Harbor Theater · Membership application form (for new memberships and renewals)

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Membership application form (for new memberships and renewals)

ALL MEMBERS ENJOY:

$2 discount off regular ticket price
Free admission to Members Only Events
Weekly Movie Newsletter from our Program Director

Your membership is valid for a one year period upon reciept of payment.

A Family membership allows you and up to four family members to take advantage of the member discount.

Contact Information

Name

First Name

Last Name

Primary Phone

Second Name

First Name

Last Name

Phone

Primary Mailing Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Secondary Email

Seasonal Mailing Address

Address Line 1

Address Line 2

City

State/Province

ZIP/Postal Code

Country

Seasonal Mailing Address Date: from mm/dd/yyyy

(mm/dd/yyyy)

Seasonal Mailing Address Date: to mm/dd/yyyy

(mm/dd/yyyy)

Is this a new membership or a renewal?

This is a new membership.

This is a membership renewal.

Is this an Individual or Family Membership?

$40 - Individual membership

$75 - Family membership (Good for a family of up to 5 members.)

Would you like to make an additional donation?

After clicking the Submit button below, you will be taken to a secure payment window. After clicking on the PayPal button, you will be able to choose to pay with your PayPal account or with your debit or credit card. All major credit cards are accepted.

Add 3% to my total amount to help cover the payment processing fees