Become a Member!

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Become a Member!

Please use this form to enroll as a member of the Creative Arts Council/Creative Arts Center. Your membership entitles you to join any of our classes, events, and Board of Directors. Your support allows us to bring wonderful arts programs to this area. Thank you!

Your name *

Name of other family member (if more than one name, add names under "Comment")

Mailing address *

City / State / Zip *

Phone *

May we send you our newsletter?

yes

Clear selection

Would you be interested in volunteering?

yes

Clear selection

Which class(es) have you joined or plan to join?

Dance (Creative Arts Dance Studio)

Pilates

Circuit Training

Yoga

Art for adults

Art for children

Piano

Banjo/Ukulele

Other:

Membership Type: *

Individual ($25/year)

Family ($35/year for the first 4 members, plus $5/year/additional family members)

$5 additional for 5th family member (if more than 5, check "Other" and explain in "Comment")

Other

Donation

Required

Total due: *

I will pay the total due by: *

Check made out to "CAC" and mailed to PO Box 1164, Eureka, MT 59917

Cash delivered to the CAC at 300 First Avenue West, Eureka, MT

Paypal or credit/debit card (see payment button to the right)

I have already submitted my payment

Other:

Comment

Please provide two emergency contacts here

Name and phone number #1 *

Name and phone number #2 *

Preferred doctor or clinic and phone number *

Known allergies

We ask you to sign and date the Hold Harmless and the Photo Release forms, which are available on the rack just inside the front door. Thank you!

Submit

Clear form

Never submit passwords through Google Forms.

Forms

This form was created inside of Creative Arts Council.