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Billing Contact Name
*
First
Last
Enter the name of the person who should be contacted if membership becomes available or with any questions regarding the wait list application.
Hollin Hills Resident?
*
Yes
No
If yes, please ensure your residence is on this map https://static1.squarespace.com/static/5f6e280f9874266a30228264/t/5f8c641c5688f32ed119bf8e/1603036189399/HH-Map-For-Website.png
Swim Team Interest?
Yes
No
Number of Household Members
1
2
3
4
5
6
Address
*
Street Address
City
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State
ZIP Code
Phone
Email
*
User Name
*
Please select a user name for your wait list account. You will be able to log in and check your status on the list as well as manage your wait list account with it. *NOTE: If you are already a member or on the wait list at another Member Splash club you will have to pick a unique username for this particular club.
Password
*
Enter Password
Confirm Password
Strength indicator
Select a password that you will use to access your wait list account. You will be able to send a password reset link to the email address you entered above if necessary.
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