Lifetime Member Registration Form

Individual (one human!)Family (people living together in the same household)

Your Name*

First NameLast Name

Email*

example@example.com

Additional Adult Family Member (to be included in the family membership)

First NameLast Name

Email Address for Additional Adult Family Member (if they would like to receive communications directly)

example@example.com

Full names of any children or other family members you wish to have included on the Elmer's membership list!

Mailing Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

I live in Ashfield full time!I live in the Hilltowns full timeI live in the Pioneer Valley or the BerkshiresI live part-time in Ashfield or a neighboring communityI come to visit Ashfield sometimes :)Other

Why are you excited to join the Elmer's Community?

Choose either INDIVIDUAL or FAMILY Membership below, then select the amount you are able to pay for your one-time membership fee.*

Elmer's INDIVIDUAL Membership - Sliding Scale

The full fee for INDIVIDUAL membership is $99. Or pay what you can! Choose the amount you're able to contribute below. If you would like to apply a prior donation towards membership, choose the last drop down item.

$99.00 Quantity
Item subtotal:$0.00

Elmer's FAMILY Membership - Sliding Scale

The full fee for FAMILY membership is $199. Or pay what you can! Choose the amount you're able to contribute below. If you would like to apply a prior donation towards membership, choose the last drop down item.

$199.00 Quantity

Total

$0.00

Payment Methods

Credit Card

Apple Pay

Google Pay