Membership Renewal Application « Lutz Children's Museum

Lutz Children’s Museum Membership Renewal Application Form

Membership is for two adults living in the same house and their children or grandchildren. All memberships expire on December 31st.

Please complete the form below and click on the submit button.

Please take a moment and verify that all the information you entered is accurate.

Membership Renewal Application

LCM Only MembershipReciprocal MembershipLCM Only + Caregiver MembershipReciprocal + Caregiver Membership

Patron ID #

Adult's Name & Gender *

2nd Adult's Name & Gender

Street Address *

City *

State *

Zip Code *

Email *

Home Phone *

Child's Name, Gender & Birth Date *

2nd Child's Name, Gender & Birth Date

3rd Child's Name, Gender & Birth Date

Caregiver Options

Only needs to be filled out if applying for a membership option that includes a caregiver.

Free admission and member benefits at LCM (Including other museums and science centers with reciprocal option). Includes one (1) caregiver.

Caregiver Name & Gender

Street Address

City

State

Zip Code

By submitting this application, I affirm that the facts set forth in it are true and complete. Once you submit your membership renewal application you will be taken to the payment page to complete your membership renewal.