2024 Membership Application Form

2024 Membership Application
New Member - $450 (This includes the $100 bond fee)

Returning Member - $350
Are you a new member or a returning member?*
In order to select a returning member, you must have a bond already. This does not include previous summer members.
Head of Household*

First NameLast Name
Spouse/Partner

First NameLast Name
Head of Household Email*
example@example.com
Spouse/Partner Email (If Applicable)
example@example.com
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Head of Household Phone*

Area CodePhone Number
Spouse/Partner Phone (If Applicable)

Area CodePhone Number
Emergency # (Relative or Friend)*

Area CodePhone Number
Family Members:

Please include up to five family members that you would like to add to your membership.
Head of Household Name*
First and Last Name
DOB*
Member Name
First and Last Name
DOB
Member Name
First and Last Name
DOB
Member Name
First and Last Name
DOB
Member Name
First and Last Name
DOB
Member Name
First and Last Name
DOB
Member Name
First and Last Name
DOB
Member Name
First and Last Name
DOB
Member Name
First and Last Name
DOB
Member Name
First and Last Name
DOB
Member Name
First and Last Name
DOB
Medical Information

Please indicate below, if any of the listed children above, have medical condition related to water activity.
Child's Name
Current health condition(s)
Child's Name
Current medication(s)
Child's Name
Physical limitation(s)
Child's Name
Allergies (insect, food, etc.)
Family Doctor*

First NameLast Name
Phone Number*

Area CodePhone Number
In the event that I cannot be reached in an emergency, I hereby give permission to the emergency medical service or physician selected by Oak Hill Recreation, Inc., employees, or a board member to secure proper medical attention for my child(ren) as listed above. All medical information listed above will remain confidential unless prohibited by law.

Also, we shall not hold Oak Hill Recreation, Inc. or any person(s) present liable if we become ill with any infectious disease while swimming at Oak Hill Pool. It is our responsibility to maintain social distance and take necessary precautions as we see fit.

By signing this waiver below, we hereby agree to the above information and certify that we have read the pool rules (click on the terms & conditions tab), and all family members listed on this application shall adhere to them accordingly.
Type in your first and last name to sign your name
Oak Hill Recreation, Inc.

Mailing Address: 1010 Plantation Dr. Victoria, TX 77901

For Questions, please call or text Jennifer at 361-676-2603
How will you be making your payment today?*

Pay below with credit or debit cardPlease use coupon code "Member" if paying with Check, Money Order, or Cash (contact Jennifer above)

My Products

New Member (This includes the one-time bond fee)$450.00

Pay in full

New Member Payment Plan$225.00

Remaining $225 paid by June 1, 2024 *failure to complete payment plan will result in a forfeit of the initial payment

Returning Member Payment Plan $350.00

Pay in full

Payment Plan for Returning Members only$175.00

Remaining $175 paid by June 1, 2024 *failure to complete payment plan will result in a forfeit of the initial payment

Enter coupon

Total $0.00

Payment Methods

Debit or Credit Card

First Name

Last Name

Credit Card Number

Security Code

Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

Should be Empty:

2024 Membership Application

Medical Information