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Kids Club Membership Form

Your gift is tax deductible and goes to support children's programming on OPT!

Pick a membership level:

$ 5.00 MONTHLY -- Sustaining Membership (our most popular!)
$ 40.00 ANNUAL -- Basic one-year membership
$ 60.00 ANNUAL -- Full one-year membership (includes OPT Passport)
$ 100.00 ANNUAL -- Even more to support kids programming!
$ 10.00 ANNUAL -- Discount membership (promo code required - enter below)

PROMO CODE:

MONTHLY -- Sustaining Membership (our most popular!)|ANNUAL -- Basic one-year membership|ANNUAL -- Full one-year membership (includes OPT Passport)|ANNUAL -- Even more to support kids programming!|ANNUAL -- Discount membership (promo code required - enter below)|

Special Benefits of Kids Club

Each child on your membership will receive the following:

• Personalized welcome letter
• FREE admission to Seuss Science Day
• Name aired on television 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.

Kid First and Last Name

Kid Birthdate

Birthdate Required

Kid First and Last Name

Kid Birthdate

Birthdate Required

Kid First and Last Name

Kid Birthdate

Birthdate Required

Kid First and Last Name

Kid Birthdate

Birthdate Required

Kid First and Last Name

Kid Birthdate

Birthdate Required

Kid First and Last Name

Kid Birthdate

Birthdate Required

Kid First and Last Name

Kid Birthdate

Birthdate Required

Kid First and Last Name

Kid Birthdate

Birthdate Required

Kid First and Last Name

Kid Birthdate

Birthdate Required

Kid First and Last Name

Kid Birthdate

Birthdate Required

Billing Information

Please use the billing address associated with your credit or debit card. (If your mailing address differs from your billing address, let us know in the "Comments" box below.)

First and Last Name

Billing Address

City

State

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Zip Code

Phone Number

Email Address

Comments:

Payment Authorization

Charge my credit or debit card (you'll enter your info on the next screen)

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Today: 7/23/2018