MOPS 2020-21 Registration Form

Plymouth Covenant Church MOPS/MOMSnext 2020-2021 Registration Form
We are excited for another year of MOPS! Our theme this year is Rise Up. What a perfect theme for our current times. There are two ways you can join for MOPS this year:

Morning MOPS Connect: On the 1st and 3rd Mondays of each month from 9:30-11:00 starting on October 5th we will offer MOPs connect. MOPS connect is a time to connect, play and hear about Jesus with moms and their kids in our church parking lot until weather moves us into the gym. Food will be provided.

Morning Meeting Dates: Oct 5, Oct 19, Nov 1, Nov 16, Dec 7, Dec 21, Jan 4, Jan 18, Feb 1, Feb 15, Mar 1, Mar 15, Apr 5, Apr 19, May 3, May 17

Evening MOPS: We are also offering a traditional MOPS in the evening from 7-9 pm on the 2nd and 4th Mondays of each month starting on October 12th. Evening Mops will be a time to connect with your table, pray with your Mentor mom, and listen to great speakers on how to grow in your faith and grow as a mother. Food will be provided.

Evening Meeting Dates: Oct 12, Oct 26, Nov 9, Nov 23, Dec 14, Dec 28, Jan 11, Jan 25, Feb 8, Feb 22, Mar 8, Mar 22, Apr 12, Apr 26, May 10, May 24
*PLEASE NOTE: Our morning MOPS/MOMSnext program is currently full. If you would like to be added to the waitlist please click HERE and fill out the form.
Evening MOPS/MOMSnext still has room! If you would like to join us please fill out this form and we'll see you soon!
Full Name *

First Name Last Name
Phone Number *

Area Code Phone Number
E-mail *
Birth Date

Month Day Year
Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
How did you hear of Plymouth Covenant MOPS/MOMSnext? *
Home Church (if applicable)
Are you expecting a little one to join your family this upcoming year? We would love to bless your family with meals around the time you expect them to arrive. *

Yes No
Your due date.

Month Day Year
Which group will you be attending? *

Morning MOPS Connect Evening MOPS
Do you have a Table Friend Request? Enter their name here:

Childcare Information (collapse)
Morning MOPS Kids Childcare Information
Number of Children requiring Childcare/MOPS Kids: *
Childcare is only for children birth to kindergarten. If you have more than 7 children needing childcare, please contact us at pccmops@gmail.com. *(If you are a leader and your school age children will be attending our homeschool class, please include them also).*
First Child

First Name Last Name
Birth Date

Month Day Year
Does this child have any special needs/allergies? If so, tell us about them here.
Second Child

First Name Last Name
Birth Date

Month Day Year
Does this child have any special needs/allergies? If so, tell us about them here.
Third Child

First Name Last Name
Birth Date

Month Day Year
Does this child have any special needs/allergies? If so, tell us about them here.
Fourth Child

First Name Last Name
Birth Date

Month Day Year
Does this child have any special needs/allergies? If so, tell us about them here.
Fifth Child

First Name Last Name
Birth Date

Month Day Year
Does this child have any special needs/allergies? If so, tell us about them here.
Sixth Child

First Name Last Name
Birth Date

Month Day Year
Does this child have any special needs/allergies? If so, tell us about them here.
Seventh Child

First Name Last Name
Birth Date

Month Day Year
Does this child have any special needs/allergies? If so, tell us about them here.
Please check the appropriate boxes below to give MOPS child care workers permission to assist your child with the following (all MOPS child care workers are required to pass a background check). I give permission, when necessary, for one MOPS adult or junior worker to:
Change my child's diaper under the Nursery Guidelines for care and hygiene. *

Yes
Escort my child to the restroom. I understand that my child should be capable of independently caring for his/her bathroom needs and, if requested, the worker may assist with basic tasks of care and hygiene. *

Yes
As a participant of MOPS and a parent/guardian of the child(ren) listed above, I give permission to Plymouth Covenant to publish for its own use any pictures of myself or my child taken during this program. *

Yes

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Registration Fees
With each registration, you will receive a MOPS International welcome kit and an annual subscription to "Hello, Dearest" magazine and weekly emails with Godly inspiration.

Registration Payment *

Morning MOPS/MOMSnext, with Childcare (Session 2 Only) $ 85.00

Morning MOPS/MOMSnext, NO Childcare (Session 2 Only) $ 60.00

Evening MOPS/MOMSnext, NO Childcare (Session 2 Only) $ 60.00

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**You must pay in order to be registered

**If the full payment at this time would be a financial burden to your family and you would like to pay for half the year now and half later, or if you are needing a scholarship please contact Char Peterson at char@plymouthcovenant.org with all of your information (including children's information) and how much you are able to pay.
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Plymouth Covenant Church MOPS/MOMSnext 2020-2021 Registration Form

Morning MOPS Kids Childcare Information

Registration Fees