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Mom Time- a safe space for moms to get together to support each other through Christ
1.
Name
2.
Email and/or phone number
3.
How many child/children do you have?
4.
Ages of child/children (use comma to separate)
5.
Which day of the week works best for you to attend Mom Time (click all that apply)
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Not Interested
6.
What time is best for your schedule to attend Mom Time
7.
Where would you prefer to meet for Mom Time?
Church
Someone’s house
Coffee shop
Other (please specify)
8.
What has stopped you from attending Mom Time? (Example: childcare, day of the week, time, etc)
9.
Would you like to be contacted with updates on Mom Time?
Yes
No
Other (please specify)
10.
Any thing you would like to add or have questions about regarding Mom Time?