2020 Membership Application: Online Form
P.O. Box 372 Stn "C"
St. John's, NL A1C 5J9
Effective January 1-December 31, 2020
Please fill out all fields, INCLUDING the digital signature at the bottom, and click submit when complete. Memberships are valid when funds are confirmed as accepted by the NLEA treasurer.
For questions relating to completing this form, please email
Date of Birth
Previous NEA Membership Number (if applicable)
Mailing address (this is where your membership card will be sent)
Alternative Phone Number
Each member will be issued a separate membership number. For insurance purposes, you must include Name, Relationship, Birth Date and previous membership number if known.
Membership Fees (please check all that apply)
Individual Junior Membership (18 years of age or younger as of January 1, 2020): $40
Individual Senior Membership (19 years of age or older as of January 1, 2020): $40
Family Membership (Definition: Open to a maximum of two people; one parent and one child 18 years of age or younger): $70
Additional Juniors (added on to the family membership): $10 per child
Club/Corporate Affiliation (Please specify participation in Statistical Information): $65
NLEA Optional Insurance Program
$50,000 Optional Accidental Death & Dismemberment (ADD) with fracture and dental benefits: $40
$10,000 Members Named Perils: $25
$10,000 Members Tack: $50
Horse & Pony Magazine
Reduced annual subscription (Mailed Quarterly): $15
Total Amount Due:
Payment is accepted by cheque, cash, or e-transfer to
. Memberships are non-refundable. Please make cheques payable to: Newfoundland & Labrador Equestrian Association. If sending an etransfer, please use the password: NLEA2020 (case sensitive). In the space below, please indicate the total amount due for your membership(s):
This information is collected to assist the NLEA in future program and service development, grant applications, government reporting, and focus areas.
Industry Participation (Please select all that apply):
Breeds & Industry
Primary Discipline (Please select all that apply):
Special Interests (Please select all that apply):
The following information is MANDATORY to process memberships. Please check, where applicable, and provide consent:
Electronic Communication Consent: Please read the following statement, and indicate your agreement by checking the box.
I CONSENT to receive information electronically from the NLEA such as notices for events and activities. The NLEA recognizes the privacy of individuals with respect to their personal information and is committed to ensuring the privacy of its members
Volunteer: Would you like to hear about NLEA volunteer opportunities throughout the year?
YES: Please contact me about volunteering.
NO: I am not able to volunteer at this time. Please do not include me on the volunteer list.
Parental Consent: If there are Junior Members included in this application, this section MUST be filled out.
For applicants aged 18 or younger (as of Jan. 1, 2020), I declare I am the parent or legal guardian for said minor(s) and I hereby give my consent for named minor(s) to become a member of the NLEA
MANDATORY ELECTRONIC SIGNATURE REQUIRED
I, the undersigned, hereby declare the information provided in this application to be true and accurate. Falsifying information could possibly null and void insurance in the event of a claim. (Please print name of applicant, or parent/legal guardian of Minor applicants):
By checking this box, I certify that my electronic signature is binding:
YES my electronic signature is binding
BENEFITS OF MEMBERSHIP
IMPORTANT INSURANCE INFORMATION
The Descriptions of coverage have been prepared for information purposes only.
The insuring agreements, general terms, conditions and exclusions of the actual policy will govern specific application of the various coverages referred to herein. In all cases the actual policy documents will supersede these descriptions. Please be advised a nominal administrative fee is collected by the NLEA for all optional insurance purchased.
The insurance coverage included and / or available as an option with your Newfoundland Equestrian Association Membership is provided to you by Intercity Insurance Services Inc.
The NLEA is not licensed to sell or provide counsel on the insurance coverage.
Please contact Intercity Insurance directly for any questions regarding coverage, limitations or exclusions at 1-888-394-3330 (Equine Department).
AUTOMATIC INSURANCE PRODUCT DESCRIPTIONS
$5,000,000 Personal Liability Insurance ($1000 Property Damage Deductible)
Protects you, the member, if you are sued by a third party because a horse that you own or lease, ride or
Handle non-commercially, causes property damage or bodily injury to a third party. **Liability coverage is for non-commercial equine related activities. Some limitations and exclusions apply. Coverage is in force, 24 hours a day, seven days a week, and covers the member (Canadian Resident) anywhere in the world. (Exclusions apply for members who are non-Canadian residents)
$30,000 Accidental Death & Dismemberment Coverage
Covering you, the member, should you suffer a catastrophic injury, dismemberment or death arising from equine related activities. (Under the age of 90 and only available to Canadian Residents)
OPTIONAL INSURANCE PRODUCT DESCRIPTIONS
NLEA Optional Accidental Death & Dismemberment INCLUDES Fracture and Dental Benefits (ADD) 2020- $40.00
$50,000 -Enhanced Accident, Death and Dismemberment for injuries sustained by you, the member related to horses, including coverage when you are en route to and from an equine activity in a vehicle. This policy will pay regardless of any other insurance that may be in force at the time of the incident.
*Enhanced AD&D is restricted to members who have not reached the age of 75 years
NLEA Members Named Perils 2020 -$25.00
$10,000 –Horse Mortality (Named Perils). Horse(s) you own are covered for death arising from Fire, lightning, transportation, earthquake or flood, attack by dogs or wild animals. Limit of $10,000 any one loss and any one term. Includes compensation for government ordered destruction of horse. This policy must be purchased by the owner of the horse(s).
NLEA Members Tack 2020 - $50.00
$10,000 –Tack and Equipment - Insurers tack and equipment from loss or damage anywhere in Continental US/Canada. Tack and horse equipment you own, excluding rider clothing and protective equipment is insured against loss or damage from "all risks". Limit of coverage is $10,000 for any one loss, total limit per term. Losses subject to deductible of $500.00
Travel (out of Province/Country) Coverage -Member Only 2020 –
Travel insurance is available to members of any age, once you have purchased your NLEA membership you will be provided with a link in which you can purchase travel insurance. Travel insurance is customized to your individual requirements.
***Please note that the optional insurance does not come into effect until Jan 1st, 2020.
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