MOMS Club of Taylor Ranch
Membership Application and Liability Release


All members must have a signed membership liability release on file with the local MOMS Club chapter before attending any activities or programs.

First Name
 Last Name
 Phone #
Address
Email Address
 Zip Code
Family Members
(please list husband and children)
Relationship to Member
Birthdays
(kids only)




Current or previous employment/volunteer work
Hobbies/interests
How did you hear about us?
What opportunities might you like to take advantage of within the
MOMS Club of Taylor Ranch?
(please check all that apply)

Babysitting Co-op

Children'sActivities

MOMS Night Out

MOMSActivities

Service Project

Defined Fitness discount membership

Meals For MOMS

Crawler Playgroup (birth to 18 months)

Toddler Playgroup (18 months to 3 years)

Preschool Playgroup (3 years and up)

Individual Playgroups (arranged by age, usually a group of 4 to 6 moms)
  Please list the ages of your children for which you
would like a playgroup:


I, the abovesigned/undersigned, understand that my participation and the
participation of any members of my family in any moms club activity or
program is completely voluntary, and we hereby give permission for myself
and my family to join in those activities or programs.
My family shall hold harmless this local moms club, the moms club corporation,
any moms club volunteers or representatives, paid or unpaid, and/or the
providers of any activity or program location and/or materials from any liability
and/or responsibility for any accident, illness or injury that occurs during or as
a result of any function or program.
I accept that final responsibility for my safety and that of my family rests with me.
Signature   Date