Membership Application

Become a member

Please fill out the Membership Application below and give 48 hours for account approval.

First Name

Last Name

E-mail Address

Address

City

State

Zip code

Phone Number

Birth Date

By checking this box, you affirm that you are 21 or older and assume all liability.

Yes

Do you agree to follow the rules and regulations of the club?

YesNo

Do you support the private adult use of Entheogenic plants?

YesNo

Do you think adults should have a safe place to use and/or acquire Entheogenic plants

YesNo

Who were you referred by? Or where did you hear about Lynx?

Why do you want to be a member?

Only fill in if you are not human

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