2025 Membership Application Form

Chesley Saddle Club Membership Form
For e-transfers:

To assist with seccurity of our funds, an assigned e-transfer password will be provided in the jotform registration confirmation e-mail. This password must be used for your transfer to be accepted.

If you can not locate this password, please message the treasurer or Donna Pollard for help.

Thank You for your understanding.

Individuals on this form need to be from the same household. Please complete a new form for individuals of a different address.
Registrant 1*

First NameLast Name
Membership Type

Non- RiderIndividualFamily
Email
example@example.com
Registrant 2

First NameLast Name
Membership Type

Non- RiderIndividualFamily
Complete if you selected the Family Membership and have several dependents.
Indicate Last name if Different from the adult registering.
1. First Name Last Name
2. First Name Last Name
3. First Name Last Name
4. First Name Last Name
5. First Name Last Name
6. First Name Last Name
Email
example@example.com
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Emergency Contact Information

(This is optional, but encouraged)
Name

First NameLast Name
Phone Number
Please enter a valid phone number.
My Products*
prevnext( X )
1 Year Individual MembershipLimit to two per form
$30.00CAD Quantity



Non Rider MemberLimit to two per form
$10.00CAD Quantity



Family Membership2 adults and up to 6 dependents under the age of 21
$75.00CAD Quantity



Total

$0.00CAD
Upload proof of insurance here.

Cancelof
I/We wish to apply for membership for the 12 month period from January 1 to December 31, 2025 and agree to comply with the club Constitution and Bylaws, Trail Ride Rules and other rules that are set by the club. By clicking agree below I/We agree to waive any claims for damage sustained by my horse, equipment or person while participating in any Chesley Saddle Club activities and further agree to hold harmless the Land Owners, while proceeding through their property, Chesley Saddle Club member, hosts, its officers or quests. I further agree that the Chesley Saddle Club, its members, hosts, officers and land owners are not responsible for the enforcement of Club or Land Owner rules and that any failure to enforce such rules will be deemed not to be negligence on the part of the Chesley Saddle Club. I agree that I am responsible for my own safety and for the safety of my family and that any Chesley Saddle Club activity will be entered into exclusively at my own risk. I certify that I have the correct insurance to participate in riding events. This also applies to my heirs, executors or assigns. I further state that I have read and understood the above.
Checking yes indicates you agree with this form and have completed it truthfully.*

I agree
Print, Complete and Upload Completed Acknowledgment of Risk and Release of Liability
Should be Empty:

Chesley Saddle Club Membership Form

Individuals on this form need to be from the same household. Please complete a new form for individuals of a different address.