Chess Valley Bridleways Application Form

2008 - 2009

FULL NAME:	(Mr, Mrs, Miss)
ADDRESS:
		POST CODE:
TEL:	(if you wish to receive communications via) e-mail:

PLEASE COMPLETE EITHER OPTION 1 OR OPTION 2

Option 1 – MEMBERSHIP ONLY

CVBA MEMBERSHIP ONLY		No. Required		Cost
Family Members	@ £16
Individual Members	@ £8
		TOTAL	£

OPTION 2 – MEMBERSHIP & TRACK LICENCE

Licence will be valid from 15^th April 2008 to 14^th April 2009

MEMBERSHIP INCLUDING TRACK		No. Required		Cost
Family	@ £50
Individual	@ £25
Junior – under 16	@ £20
Replacement/New Disc	@ £2
		TOTAL	£

Horse / Pony Stabled at
Previous Disc No.
I am insured with
	(BHS Gold Membership & Pony Club Members have Third Party Insurance, Riding Club Members DO NOT)

· The Disc, which is non-transferable, must be displayed.

· Riders not displaying their Disc may be challenged and turned back.

· The ‘Waymarked’ Tracks are as per map.

· Care must be exercised concerning farm traffic particularly at harvest time.

I confirm that I have third Party Insurance

I undertake to ride only on the ‘Waymarked’ Tracks and to ride with CONSIDERATION and CARE

I have read all the above and agree to the terms stated

Signed:____________________________________________________Date:___________________

(THE CVBA RESERVE THE RIGHT TO WITHOLD A LICENCE WITHOUT GIVING A REASON)

PLEASE SEND THIS FORM WITH YOUR REMITTANCE (cheques payable to C.V.B.A)

TO: Mo Sims, 2 Cranefield Drive, Garston, Watford, Herts WD25 9TX – 01923 491636