Kids Club Membership Form

Your membership is tax deductible and goes to support children's programming on OPT -- thank you! Will this be a one-time gift or a monthly sustaining gift?

Donation Amount

How much would you like to give?

Summary of Benefits:

Membership benefits include:

  • OPT Passport
  • Monthly program guide


Each child on your membership will receive the following:

  • Personalized welcome letter
  • Personalized birthday card
  • Name broadcasted LIVE on OPT during entire month of child's birthday
  • Special mailings throughout the year


Child(ren)'s Name and Birthday

Click "Add Kid" for each child you wish to enroll (limit 3 children, age 12 or under).

Kid First and Last Name
Kid BirthdateAn icon denoting this is a required field
Drop Down Calendar
Clear Kid Info
Kid First and Last Name
Kid BirthdateAn icon denoting this is a required field
Drop Down Calendar
Clear Kid Info
Kid First and Last Name
Kid BirthdateAn icon denoting this is a required field
Drop Down Calendar
Clear Kid Info
Kid First and Last Name
Kid BirthdateAn icon denoting this is a required field
Drop Down Calendar
Clear Kid Info
Kid First and Last Name
Kid BirthdateAn icon denoting this is a required field
Drop Down Calendar
Clear Kid Info
Kid First and Last Name
Kid BirthdateAn icon denoting this is a required field
Drop Down Calendar
Clear Kid Info
Kid First and Last Name
Kid BirthdateAn icon denoting this is a required field
Drop Down Calendar
Clear Kid Info
Kid First and Last Name
Kid BirthdateAn icon denoting this is a required field
Drop Down Calendar
Clear Kid Info
Kid First and Last Name
Kid BirthdateAn icon denoting this is a required field
Drop Down Calendar
Clear Kid Info
Kid First and Last Name
Kid BirthdateAn icon denoting this is a required field
Drop Down Calendar
Clear Kid Info
Add Kid

Billing Information

Please use the billing address associated with your credit or debit card.

First and Last NameAn icon denoting this is a required field
Billing AddressAn icon denoting this is a required field
CityAn icon denoting this is a required field
StateAn icon denoting this is a required field
Zip CodeAn icon denoting this is a required field
Phone NumberAn icon denoting this is a required field
Email AddressAn icon denoting this is a required field
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