Membership Sign-Up
If you have an emergency, please dial 911
Signing up for a Lancaster EMS membership online via this form requires payment via PayPal. PayPal supports a large number of credit cards, including Visa, MasterCard, American Express, Discover, and several other payment services. If you'd rather pay via check or money order, please download our flyer and follow the payment instructions.
Fields denoted with a '*' are required to complete registration. The PayPal button will not be available until all these fields are entered.
Choosing the right type of membership:
  • If you'd like to cover one person under the age of 60, select "Individual"
  • If you'd like to cover one person over age of 60, select "Single Senior"
  • If you are covering a couple under 60, or you'd like to cover three of more people, select "Family"
  • If you are covering a couple over 60, select "Senior Couple"
  • In order to minimize abuse/spam, please check the reCAPTCHA check box: