Exhale 2018
Membership Registration

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* 1. Member Contact Information:

Name *

Address *

Address 2

City/Town *

State/Province *

ZIP/Postal Code *

Country

Email Address *

Phone Number *

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* 2. We are so glad you are joining us this year! Will you plan to attend morning or evening meetings?

Tuesday Mornings from 9:30-11:30

Wednesday Evenings from 5:30-7:30

Both morning and evening meetings depending on the date.

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* 3. If you answered both to question 2, please respond to the following , or select Not Applicable.

Mainly Mornings

Mainly Evenings

Not Applicable

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* 4. Please complete all questions, (4-6) below, pertaining to your child or children.

First & Last name of child
(1 name per line please)

Child 1:

Child 2:

Child 3:

Child 4:

Child 5:

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* 5. Please list your childs' birthday.

(Please use the following format for entering information below ; i.e. 5/6/2011 , IF this question does not apply to a child, please state N/A).

Child 1 DOB:

Child 2 DOB:

Child 3 DOB:

Child 4 DOB:

Child 5 DOB:

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* 6. Please list any allergies or medical concerns specific to each of your children.

(If nothing applies to a child, please state "N/A" in the answer space)

Child 1 (Allergy / Medical):

Child 2 (Allergy / Medical):

Child 3 (Allergy / Medical):

Child 4 (Allergy / Medical):

Child 5 (Allergy / Medical):

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* 7. We can't wait to kick off a wonderful year with each of you as we journey motherhood together! Please make sure to come back to this Survey Monkey registration page once you've completed Q7 and Q8 to click DONE at the bottom so we receive all of the registration information you filled out above. Your Exhale registration isn't complete until you hit DONE!

Please utilize the links provided in questions 7 & 8 regarding our monthly membership/ meeting registration!

In effort to cover cost, including available childcare, we do ask that your membership fee, of $40.00, be paid at the time of registration utilizing the following link: Click Here to Pay Your Annual Dues!

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* 8. Lastly, you simply need to RSVP for yourself and your children, to our monthly meetings, utilizing the sign-up genius link provided. RSVP Link: Click Here to RSVP for our monthly EXHALE Meetings!

Once you have completed the registration, paid dues via Paypal link, and completed your RSVP via SignUp Genius link, PLEASE SELECT DONE (at the bottom of the survey) to FINALIZE YOUR MEMBERSHIP!

Thank you for taking time to register for our EXHALE Group! We are ready to kick off this journey with you because it is going to be so much fun!

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* 1. Member Contact Information:

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* 2. We are so glad you are joining us this year! Will you plan to attend morning or evening meetings?

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* 3. If you answered both to question 2, please respond to the following , or select Not Applicable.

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* 4. Please complete all questions, (4-6) below, pertaining to your child or children. First & Last name of child(1 name per line please)

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* 5. Please list your childs' birthday. (Please use the following format for entering information below ; i.e. 5/6/2011 , IF this question does not apply to a child, please state N/A).

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* 6. Please list any allergies or medical concerns specific to each of your children. (If nothing applies to a child, please state "N/A" in the answer space)

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* 4. Please complete all questions, (4-6) below, pertaining to your child or children.

First & Last name of child
(1 name per line please)

* 5. Please list your childs' birthday.

(Please use the following format for entering information below ; i.e. 5/6/2011 , IF this question does not apply to a child, please state N/A).

* 6. Please list any allergies or medical concerns specific to each of your children.

(If nothing applies to a child, please state "N/A" in the answer space)