2023-2024 MPPG Membership Form Please choose your membership type:* New Member Returning Active Member What year did you first join MPPG?*202320222021202020192018 or laterParent 1 Member Name* First Last Parent 2 Member Name First Last Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone Number - Parent 1*Phone Number - Parent 2Email Address - Parent 1* Email Address - Parent 2 Parent 2 Email Communication Opt In*Opt in for all email communicationOpt in for 'Dads day out' communicationOpt out of all communication Children How many children do you have?*123456Child 1: Name First Child 1: DOB Month Day Year Child 2: Name First Child 2: DOB Month Day Year Child 3: Name First Child 3: DOB Month Day Year Child 4: Name First Child 4: DOB MM slash DD slash YYYY Child 5: Name First Child 5: DOB Month Day Year Child 6: Name First Child 6: DOB Month Day Year Are you expecting?*NoYesIf yes, when are you due? Month Day Year Would you like to sign up for a playgroup?*YesYes, and I'd like to be a leader for my playgroup.NoPlaygroups are created in the fall after our opening meeting. If you join after September, we will try our best to assign you a playgroup if there is one available that is for your child's age group. If you have previously been a part of a playgroup but your needs have changed, you can request to be a part of a new group here. Which child listed above would you like to find a playgroup for?Child 1Child 2Child 3Child 4Child 5Child 6If you'd like to join more than one playgroup, please indicate which children in the notes section below.If you are planning to join a play group, please select the days & times that work best for your schedule and we will try our best to accomodate:*Not ApplicableMonday AMMonday Mid DayMonday Late AfternoonTuesday AMTuesday Mid DayTuesday Late AfternoonWednesday AMWednesday Mid DayWednesday Late AfternoonThursday AMThursday Mid DayThursday Late AfternoonFriday AMFriday Mid DayFriday Late AfternoonSaturday AMSaturday Mid DaySaturday Late AfternoonSunday AMSunday Mid DaySunday Late AfternoonYou may select as many as you'd like by using the Ctrl button on your keyboard.If you have any additional notes regarding playgroup needs, please specify below.Do you plan to graduate from MPPG after this year (is your youngest child entering Kindergarten in Fall 2024)?*YesNoPlease confirm your acceptance of the following requirements as outlined in the MPPG Procedures and Membership Agreement* Select All Members must be parents to children between the ages of birth through preschool (or are expecting). Members are required to serve on the annual Luminaria fundraiser committee (regardless if you live outside of Mariemont) and one additional committee of their choice. Members are asked to pay $20 for our Sunshine fund. Members must pay the annual dues by the date provided at the opening meeting. I agree to theTerms and Conditions of the Mariemont Preschool Parents Group Photo Release. I agree to theTerms and Conditions of the Mariemont Preschool Parents Group Assumption of Risk and Liability Wavier Form. Membership Options Price: Select from below. Membership Options* 2023-2024 MPPG Membership [$60 dues + $45 hospitality + $20 Sunshine Fund] Include My Luminaria Kit(s)! Quantity Price: $20.00 Quantity Be ahead of the game and get your Luminaria kit ordering out of the way. 🙂Donate a luminaria kit! Quantity Price: $20.00 Quantity Sign up for the Luminaria house decorating contest! Yes, I would like to participate in the house decorating contest. No thanks! Luminaria-- Carriage Ride Ticket Quantity Price: $4.00 Quantity Pre-pay for your carriage ride through Old Town Square! It is cash only day-of and the price will be $5 per person! If pre-paid, your name will be on a list at the event booth in Old Town Square. Each person over the age of 2 will need their own ticket.Total $0.00 * includes online process fees In order for your application to be complete you must hit Submit and then complete payment through PayPal Thanks for joining MPPG! CAPTCHA 94288
