Walsingham Horseman's Association - Trail Use Fee Application

Walsingham Horseman’s Association, Inc.
WALSINGHAM HORSEMAN’S ASSOCIATION
2026/27 Trail Use Fee Application

All Trail Fees are renewed annually in February.
TYPE OF FEE — CHECK APPLICABLE BOX
Contact Information:

WHA Website: WHAHorse.org

Membership Phone: 727-831-6114

Mailing Address:

WHA Membership

PO Box 3616

Seminole, FL 33775
Rules and Regulations
Guest Pass Usage
Acknowledge and Release of Liability - WARNING: Under Florida Law, an equine activity sponsor or equine professional is not liable for an injury to, or the death of, a participant in equine activities resulting from the inherent risks of equine activities.

I agree to abide by the WHA/Pinellas County Park rules, as listed on the website, as well as the WHA brochure, and understand that my privileges as a member may be revoked if those rules are not followed. I do hereby, for myself, my heirs, executors and assigns, waive, release and forever discharge any and all rights and claims for damages which I may have or hereinafter accrue against The Walsingham Horseman’s Assoc., it’s officers, agents, etc., and Pinellas County, it’s officers, agents, etc. for any damages which may be sustained by me, or my minor child(ren), in connection with my/our equestrian activities, no matter the location of said activities.
Primary Member Information

Enter your information here
Full Name
Are you under the age of 18?
Address

Mailing Address

Street Address Line 2

CityState / Province

Zip
Cell Phone
Format: (000) 000-0000.
Email
example@example.com
Emergency Contact: Name

First NameLast Name
Emergency Contact: Cell Phone
Format: (000) 000-0000.
Emergency Contact: Email
example@example.com
Relationship to Applicant
Family Members

*Must wear a helmet (if under 18) while in the park.

Which applies to you?
Horse Details

Fill in the information about the horse(s) you (and your family members, if applicable) will be riding on the trail
Horse’s Barn Name
Horse’s Registered Name
Boarding Facility Name (where your horse is kept)
Boarding Facility Address

Barn Address

Street Address Line 2

CityState

Zip
Date of Coggins

MonthDayYear
Date
Attach Negative Coggins (Optional)

Cancelof
Date of last vet exam

MonthDayYear
Date
Is the horse Microchipped?
If Yes, list the Registration Number
Member Signatures

Signature is required.
Contact WHA Membership if you have questions about this form at 727-831-6114 or info@whahorse.org.
Legal Signature

if applicant is an Adult
Legal Parent/Guardian Signature

if applicant is a minor
Additional Legal Signature

if more than one adult is included in a Family Membership
Date

MonthDayYear
Application Date
Annual Membership Renewal Day is Saturday 2/28/25 from 1:00pm to 3:00pm. Keys will be changed immediately after the event. Check one of the following:
WHA Office Use Only
Key Status
Amt. Rec’d
Amt. Rec’d
Check Number
Date Payment Received

MonthDayYear
Date
Date Key was Mailed

MonthDayYear
Date
Added to system by/date

MonthDayYear
Date

Rows	FULL NAME	RELATIONSHIP TO APPLICANT	DATE OF BIRTH IF UNDER 18*
Family Member 1
Family Member 2
Family Member 3
Family Member 4
Family Member 5

Enter coupon

WALSINGHAM HORSEMAN’S ASSOCIATION

Rules and Regulations

Primary Member Information

Family Members

Horse Details

Member Signatures

WHA Office Use Only

Payment

Membership Options (Choose one)*

Membership Options (Choose one)