Loyalty Program Sign Up

First Name

Last Name

Date of Birth -- 21+(rec)/18+(med) only

Driver's License/State ID/Passport

Choose File

Medical Marijuana Card (if applicable)

Choose File

Sex

Male

Female

Other

Either an email address and/or a phone number is required in order to successfully sign up for our loyalty program.

Phone/Mobile

State

Your Preferred La Mota Location

Favorite Way to Consume

Referred by a friend? Type their first and last name and you'll BOTH earn $10 worth of points!