Membership Application Optional Online Form Available Below Print Friendly Membership Application MEMBERSHIP APPLICATION Membership Category * Family Contributing Intermediate Individual Single Contributing New Senior Family New Senior Single Senior Family Senior Single Junior Non-Resident Associate Heritage + Honorary Member Applicant's Full Name * First Name Last Name Spouse's Full Name First Name Last Name Home Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Mailing Address (If different than above) Address 1 Address 2 City State/Province Zip/Postal Code Country Home Phone (###) ### #### APPLICANT Occupation Employer Work Phone (###) ### #### Cell Phone (###) ### #### Date of Birth MM DD YYYY Email * SPOUSE Occupation Employer Work Phone (###) ### #### Cell Phone (###) ### #### Date of Birth MM DD YYYY Email Names of Children and Birth Dates Previous Riding and Hunting Experience (include other hunt memberships) List Those Who Plan to Foxhunt Do you own land in Goochland, Louisa, Cumberland or Fluvanna Counties? Yes No Other Clubs in which you or your family are members? Why do you want to join the Hunt Club? Please check all that apply: Foxhunting Social Activities Hunter Shows Land Conservation Jumper Shows Lecture Series and Clinics Eventing Yoga Classes Pony Club/Children’s Activities Goochland or Cumberland Neighbor Use of the Show Rings Hunter Trial Field Nature Walks Trail Rides Clubhouse Rental Pool Tennis Additional Comments DRHC Members kKnown by Applicant excluding sponsors If elected to membership, I/we agree to pay the regular quarterly dues and all fees that may be applicable; and to comply with and observe the by-laws, rules and regulations of the Deep Run Hunt Club, now in force, and those that may be legally adopted. I/we also acknowledge an obligation to participate in the annual Hunt Contributions Campaign. The current voluntary Hunt Contribution levels recommended by the Deep Run Hunt Board and Masters are $650 for individual members and $1200 for family members. Every member is expected to contribute at some level to the annual Hunt Contributions Campaign and active foxhunters are expected to contribute more. Applicant Electronic Signature Acknowledgment * I agree and understand that by checking the Electronic Signature Acknowledgment, that an electronic signature is the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement. Yes No Spouse Electronic Signature Acknowledgment I agree and understand that by checking the Electronic Signature Acknowledgment, that an electronic signature is the legal equivalent of my manual/handwritten signature and I consent to be legally bound to this agreement. Yes No Date * MM DD YYYY Thank you!
