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Become a Member
Name
*
First Name
Last Name
Date of Birth
*
(mm/dd/yyyy)
Spouse/Partner's Name (optional)
First Name
Last Name
Contact Information
Address
*
Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Phone
*
Email
Verify Email
Spouse/Partner's Email (optional)
Verify Email
Mail ONLY Contact
If you are unable to recieve email notifications of upcoming programs and events, but would still like to be notified please check yes.
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No
Upcoming Event Updates
*
Are you interested in recieving emails of all upcoming events at the waterman center?
Yes
No
Membership
Membership Level
*
Please select a membership level
Individual - $25+
Family - $50+
Buisness - $100+
Contributor - $150+
Patron - $300+
Benefactor - $500+
Payment
*
$100
-
Buisness
$50
-
Family
$25
-
Individual
$
Donation Schedule
One Time
Monthly
Quarterly
Yearly
