Moai Pre-Registration Form

First Name*

Last Name*

Email Address*

Phone Number*

Zip Code*

Walking Moai

Are you interested in participating in a Walking Moai?*

Yes No Not now

Primary Interest
Monday | 4:00pm | RedondoMonday | 4:15pm | RedondoMonday & Wednesday | 6:00pm | RedondoMonday | 6:30pm | RedondoTuesday & Thursday | 7:00am | RedondoTuesday | 4:15pm | RedondoWednesday | 9:00am | RedondoWednesday | 4:15pm | RedondoThursday | 8:30 | ManhattanThursday | 9:00am | RedondoThursday | 4:15pm | RedondoThursday | 5:00pm | ManhattanThursday | 6:00pm | RedondoThursday | 6:30pm | RedondoSaturday | 8:00am | RedondoSunday | 9:00am | RedondoI'm flexibleNone of these time work for me

Secondary Interest
Monday | 4:00pm | RedondoMonday | 4:15pm | RedondoMonday & Wednesday | 6:00pm | RedondoMonday | 6:30pm | RedondoTuesday & Thursday | 7:00am | RedondoTuesday | 4:15pm | RedondoWednesday | 9:00am | RedondoWednesday | 4:15pm | RedondoThursday | 8:30 | ManhattanThursday | 9:00am | RedondoThursday | 4:15pm | RedondoThursday | 5:00pm | ManhattanThursday | 6:00pm | RedondoThursday | 6:30pm | RedondoSaturday | 8:00am | RedondoSunday | 9:00am | RedondoI'm flexibleNone of these time work for me

Comments

Potluck Moai

Are you interested in joining a Potluck Moai?*

yes No Not now

Primary Interest
Second Tuesday of the Month | 6:30-8:30pmThird Wednesday of the Month | 6:00-7:30pmSundays (dates vary) | 6:00-7:30pmI'm flexibleNone of these work for me

Secondary Interest
Second Tuesday of the Month | 6:30-8:30pmThird Wednesday of the Month | 6:00-7:30pmSundays (dates vary) | 6:00-7:30pmI'm flexibleNone of these work for me

Comments

Purpose Moai

Are you interested in joining a Purpose Moai?*

Yes No Not now

Comments

Thank you for your interest!
Participants must pre-register to participate. Please wait until you have been contacted before you attend a group meet up.

If you have any additional questions, contact Tiana
Rideout at tiana.rideout@bchd.org or 310-374-3426, ext. 139.

Send me a copy of my responses

Email address

Your submission is being processed. Please do not close this browser window until complete.