Madison Street United Methodist Church

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To participate in Mothers of Madison Street, please fill out the information below. MOMS meets on Thursdays from August 2020 - May 2021 from 9:00 - 11:00 am. The way this group will meet is dependent on what reopening phase we have entered. There is a $20 registration fee payable online or in-person by check or cash. If you have questions please email ashley@madisonstreetumc.org.

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First Name*

Last Name*

Phone (including area code)*

Email*

Verify Email*

Address*

City/State/Zip*

What is your birthday?*

Will you need child care?*

	Yes
	No

Please list the name and age of each child that child care is needed for.

I would like more information about:

	Being a table leader
	Being a mentor mom
	Being on the leadership team