• Let us know who this membership is for:
  • This membership is for my household
  • This is a gift membership for someone outside my household
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• Select	Membership Type	Description	Price
  	2-4 Person Explore	List up to 4 named individuals from one household. For more people choose appropriate level. One year of admission for listed members at the Children's Museum of La Crosse only. Guest receive $2 off regular admission; coupons cannot be stacked.	75.00
  	Grandparent Plus	List up to two named grandparents from one household as covered members (do not list children or grandchildren). One year of admission for listed member grandparents + guests for a total of 6 people per visit. This membership is ONLY valid at the Children's Museum of La Crosse. At least one named grandparent must be present at each visit. Additional guests (beyond 6 covered in membership) receive $2 off regular admission; coupons cannot be stacked.	100.00
  	Six Mix	One year of admission for listed household members + guests for a total of 6 people per visit. At least one named member must be present. Admission is valid ONLY at the Children's Mueum of La Crosse. Additional guests (beyond 6 included in membership) can receive $2 off admission; coupons cannot be stacked.	120.00
  	Passport	One year of admission for listed household members + guests for a total of 6 people per visit. At least one named member must be present at each visit. Additional guests (beyond 6 included with membership) will receive $2 off regular admission; coupons cannot be stacked. Also includes free or 50% off admission at over 400 children's & science museums. To see participating organizations see links above. Passport Membership level includes reciprocal benefits: Click here for the Association of Science & Technology Centers (ASTC) museums with free admission Click here to look for Association of Children's Museums (ACM) with 50% off admission	160.00

• Please enter the names of covered members (refer to membership level selected above) Member Adult First and Last Name/s (example: Fred and Sue Smith or Fred Smith)
  NOTE: Total # of names on card cannot exceed # allowed by membership level 
• Member Child First Name/s, separated by comma (example: Amber, Evan, Jacob)
  NOTE: Total # of names on card cannot exceed # allowed by membership level 
• Any extra member names not included on Line 1 or 2 (ex: additional adult living in household)
  
  NOTE: Total # of names on card cannot exceed # allowed by membership level
• Fourth Name on Card
• Where should we send the membership acknowledgment?
  • Directly to me
  • Directly to recipient
  • Would you like to send an email to the recipient of the membership?
• Enter primary name of person/household you are giving the membership to
  First Last
  Spouse First Spouse Last
• Email
• Recipient Address
  ZIP Code Street Address City Recipient State Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State
• Phone
• Enter names of covered members (refer to membership level selected above)
  
  
  Member Adult First and Last Name/s (example: Fred and Sue Smith or Fred Smith)
  NOTE: Total # of names on card cannot exceed # allowed by membership level 
• Member Child First Name/s, separated by comma (example: Amber, Evan, Jacob)
  NOTE: Total # of names on card cannot exceed # allowed by membership level 
• Any extra member names not included on Line 1 or 2 (ex: additional adult living in household)
  
  NOTE: Total # of names on card cannot exceed # allowed by membership level
• Fourth Name on Card
• Enter information for each child covered under this membership (gender field is required by software)
  
  
  NOTE: The system has space for up to 7 child names, but list only those covered by the selected membership level. Total # of names listed (adults + children) cannot exceed # allowed by membership level (i.e., 4-person Explore = 4 total names.)
  You may enter up to 7 Family Members below. If you have more Family Members, you may add them in 'My Account' after purchasing your Membership.
  • First Name Last Name

    Birth Date