Membership Form

Date of Birth:

Baby's name: *

Expecting

Twins

Triplets

Address: *

Email: *

Phone: *

Date of Birth: *

Baby's name:

Address: *

Parent's Name(s): *

Additional Information:

Sibling's name:

Address: *

Membership *

New

Renewal

Baby's name: *

Sibling's name:

Regina Parents of Multiples Association Membership Form

Membership fees are $30.00 per year (September - June) with renewals due each September.

Once you have completed the membership form, our Membership Coordinator will follow up with you by email to confirm we have received your membership form as well as to pass on more information.

Please contact our Membership Coordinator, Amanda Wira, at rpomamembership@gmail.com if you have any questions.