Become a Living Desert Member Today!

Membership Application

Please complete all form fields that apply.
Application type:
 New Member
 Renewal
 Gift Membership (please fill the gift information section at the bottom)
 
All categories include unlimited free day time admission.
Membership type: 

Personal Information:

Please put information about you in this section.
 
Salutation:
First Name:
Middle Name:
Last Name:
 
Second name on membership:
Salutation:
First Name:
Middle Name:
Last Name:
 

Contact Information:
Primary Address
Street:
Apt. #:
City:
State/Province:
Zip/Postal Code:
Country
Home Phone: (Must include area code)
Mobile Phone: (Must include area code)
Other Phone: (Must include area code)
E-mail:
 
Secondary Address (Summer Home)
Street:
Apt. #:
City:
State/Province:
Zip/Postal Code:
Country
Home Phone: (Must include area code)
Mobile Phone: (Must include area code)
Other Phone: (Must include area code)
 
Date for Primary Address: (mm/dd/yyyy)
Date for Secondary Address: (mm/dd/yyyy)
 

Gift Membership Information:
Please fill out below if this is a gift membership for someone else.
 
Name on gift card
(if different from above):
Relationship:
 
Send gift membership to (if different from above):
Street:
Apt. #:
City:
State/Province:
Zip/Postal Code:
Country
 
Send gift membership to:  Me  Gift Recipient
 
 
Memberships are good for ONE YEAR from the month of purchase. Memberships
are non-transferable and non-refundable. Please allow 7 days for processing.