Walsingham Horseman's Association - Trail Use Fee Application

Walsingham Horseman’s Association, Inc.
WALSINGHAM HORSEMAN’S ASSOCIATION
2025/26 Trail Use Fee Application

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

Single (One vote)Family (Two votes)Student* (No vote)
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*

I understand that a guest pass requires approval by the board of directors prior to access to the park. Once approved, guests must sign a WHA release of liability and pay a one-time $10 trail fee (if riding, the guest must be accompanied when riding on the trail by a member at all times). Separate WHA form required. Send request to info@whahorse.org
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?*

YesNo
Address*

Mailing Address

Street Address Line 2

CityState / Province

Zip
Cell Phone*
Email*
example@example.com
Emergency Contact: Name*

First NameLast Name
Emergency Contact: Cell Phone*
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?*

Check if you Lease a horse.Check if you Own a horse.Check if neither apply 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?*

YesNo
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 *

Clear
if applicant is an Adult
Legal Parent/Guardian Signature*

Clear
if applicant is a minor
Additional Legal Signature

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

MonthDayYear
Application Date
Annual Membership Renewal Day is Saturday 3/1/25 from 11:00am to 1:00pm. Keys will be changed immediately after the event. Check one of the following:*

YES, I am planning to attend the Annual Renewal eventNO, I will not be attending the Annual Renewal event
WHA Office Use Only
Key Status

Key GivenKey Mailed Date:
Amt. Rec’d
Amt. Rec’d

PayPal/OnlineCheck check no
Check Number
Date Payment Received

MonthDayYear
Date
Date Key was Mailed

MonthDayYear
Date
Added to system by/date

MonthDayYear
Date

	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