Lake Parks Annual Pass
Registration Form
INTERNAL USE ONLY
Pass Exp. Date __________
Pass # (1) ___REC________
Pass # (2) ___REC________
Date ______________
Name _________________________ Phone ____________________
Address______________________________________________________________________
Street
City/State
Zip
DL #_________________ Email _______________________________
Vehicle 1 License Plate # _________________ *Vehicle 2 License Plate # ________________
*If purchasing an add-on pass for a second vehicle, must provide proof of second vehicle with a valid insurance card
Pass Type
⃝ Grapevine Resident--$35
⃝ Non-Resident--$75
⃝ *Non-Resident DISCOUNTED—$35
*Discounted passes are available to Seniors (62+), disabled, veterans or active military non-residents, proof required
⃝ Add-on 1--$20/$60
Passes can be purchased in person at:
The REC of Grapevine
1175 Municipal Way
817.410.3450
Rockledge Park
3600 Pilot Point
817.454.1058