Single Member Application | Belmead Equestrian Club

Belmead Equestrian Club Single Person Membership Application

All sections with * symbol are required in order to submit the form. Upon completion of this form you will be directed to download a Credit Card Authorization Form. Payment is taken after membership form has been submitted and reviewed. Have questions? We'd be happy to answer them. Call (804) 543-4173, Monday - Friday.

Date*
Date Format: MM slash DD slash YYYY
Member Applicant's Name*
First Last
Email Address*
Enter Email Confirm Email
Address*
Street Address Address Line 2 City State ZIP Code
Cell Phone*
Home Phone
Emergency Contact's Name*
First Last
Emergency Contact Phone*
Horse Information*
Click + symbol to add additional horses.
Horse's Name Description
Coggins Test
Please attach one or more Coggins Test(s) or email to info@belmeadequestrianclub.com Membership applications will not be complete until Coggins Tests are submitted.
Drop files here or
Coggins Expiration Date*
Date of the Coggins Expiration
Date Format: MM slash DD slash YYYY
License Plate Number of Towing Vehicle(s)*
Click + symbol to add additional license plates.
License Plate Number
Required Agreement*
Please carefully read all regulations and the attached liability Release, Waiver of Right to Sue, and Assumption of All Risks. By signing and paying your membership fee, you are agreeing to abide by these rules. A list of complete Rules is found on our website at Belmeadequestrianclub.com Failure to comply with any of these requirements may result in the immediate suspension or cancellation of your membership.

General
• RIDING IS AT YOUR OWN RISK.
• All payments must be made on time. Membership shall be revoked if payments are not made when due.
• Belmead is open to ride daily from 30 minutes after sunrise until 30 minutes before sunset
• The front gate is locked after dark; the speed limit is 25 mph.
• Anyone riding a horse must provide proof of personal liability insurance.
• Anyone riding a horse other than his or her own horse must provide proof of liability insurance.
• Firearms are strictly prohibited.
• Safety helmets that meet ASTM/STI safety standards are recommended for all riders.
• Safety helmets that meet ASTM/STI safety standards are required for children under 18.
• If you scoop manure from your trailer, please deposit it in the marked containers provided.
• All other trash must be placed in containers marked trash or taken home with you.
• Pavilion may be reserved for groups, recommended minimum 7 days advance
• Rules are subject to change at any time. Membership may be revoked in the sole discretion of management.

All Members/Riders Must
• Register upon arrival at the Rider Registration Shed.
• Saddle tag must be clearly visible from both sides of your horse.
• Maintain accurate up to date contact information with management.

Guests
• Members are fully responsible for their invited guests, including paperwork and payment of fees.
• Guest must comply with all rules, sign all forms and pay $45.00 guest fee.
• Guest should arrive at the same time and ride with the member.
• Guest must display “Guest Dash Sign” on the dash of their truck in a clearly visible manner.

Trails
• For safety reasons no animals except horses are allowed on the trails.
• All horses must be under the control of their rider/handler at all times.
• Double or bareback riding are not permitted.
• Following periods of heavy rain, some trails may be temporarily closed.
• Ride only on designated trails and respect all “no horse” signs.
• No smoking, drinking alcohol, or littering on the trails.
• If your horse kicks, please put a red ribbon on his/her tail.
• When approaching other horses on the trails, please be respectful and slow down.

Primitive Camping
• Open year round – Advance reservation required, minimum 48 hours
• Guest release requirements apply.
• Sponsoring members are fully responsible for their invited guests including paperwork and fees.
• Water is provided for the horses. Bath house on site.
• Campsites are restricted to Pavilion Park; pets must be restrained and or on a leash at all times.
• Absolutely no septic dumping!
• No night riding.

Additional Terms
• It is understood by the parties that the membership does not constitute a lease or otherwise bestow any ownership, leasehold, or other interest to Member.
• Member shall indemnify and hold harmless BELMEAD EQUESTRIAN CLUB LLC, ITS MEMBERS, MANAGERS, OFFICERS, ASSIGNS, EMPLOYEES, CONTRACTORS, CONSULTANTS, EVENT ORGANIZERS, AND/OR THE OWNERS AND/OR LESSEES OF
BELMEAD (COLLECTIVELY REFERRED TO AS “BELMEAD PARTIES”) from any and all damages claims, actions, liability and expenses (including costs of judgments, settlements, court costs, and attorney’s fees), regardless of the outcome of such claims or actions arising out of or relating in any way to Member’s membership herunder or the use by Member its family members, guests, agents, or invitees.
• Each late payment shall incur a $50 late fee and accrue interest at the rate of 18% per annum. Belmead Equestrian Club shall be entitled to recover its reasonable costs and attorneys’ fees for any action brought to collect against Member.
• Member agrees that exclusive jurisdiction for any action brought pursuant to this Membership Agreement or the use of the facilities shall be the courts of Powhatan County, Virginia. Member agrees to submit to the exclusive jurisdiction of the courts located in Powhatan County, Virginia, for any action arising under this Membership Agreement or through the use of the facilities. I have read and hereby agree to abide by these stated regulations and those listed on the website. I understand that failure to comply with these rules may result in the suspension or termination of my membership, and forfeiture of all fees paid.

By checking this box I am confirming that I have read the required agreement and hereby agree to abide by these stated regulations and those listed on the website. I understand that failure to comply with these rules may result in the suspension or termination of my membership, and forfeiture of all fees paid.
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Horse's Name	Description

License Plate Number