Blue Ridge Center for Environmental Stewardship
11661 Harpers Ferry Rd, Purcellville, VA 20132-1944
Phone: 540-668-7640 info@blueridgecenter.org, www.blueridgecenter.org
Rental Application for Demory-Wortman House
Group Name (if applicable):
Name/Group Leader/Contact Person:
Address:
Phone #’s:
City, State, Zip:
Email:
# of people staying:
Arrival Date:
Departure Date:
( maximum of 10 )
Arrival Time ( check-in 2:00pm or later ):
Departure Time ( check-out by 12:00 noon or earlier
):
The Demory-Wortman House is a historical farmstead that has been renovated for overnight use. It includes several meeting rooms, 1 full bath, 2 half baths, kitchen, 3 porches, 5 bedrooms, & 2 sitting rooms. This rustic & comfortably furnished facility is equipped with wireless internet, central heat & A/C. Capacity = 1 King, 1 Queen, 6 Twin beds (maximum # of people allowed = 10 )
Payment Info
Rates ( 2 night minimum ): $ 180 .
00 /night (Nov. 1 - March 31) $ 220 .
00 /night (April 1 - Oct. 31)
Cleaning Fee :
Security Deposit :
$ 50 .
00 (include with rental payment)
$ 100 .
00 ( This must be a separate check and must be received upon reservation confirmation.
See attached checklist for details on refundable security deposit.)
Full payment (& security deposit) due upon reservation confirmation.
REFUND : 30-day cancellation notice is required for a full refund; 15-29 day = 50% refund; 0-14 day = no refund.
Make checks payable to : BRCES , 11661 Harpers Ferry Road, Purcellville, VA 20132
BRCES Demory House Rental App, Page 1 of 6

 Bed Linens : Pillow Cases and Sheets o Flat & Fitted Sheets
– We have (1) King, (1) Queen, and (6) Twin beds o Pillow Cases – You must bring pillow cases if you plan to use our pillows
 Towels – Bath Towels, Hand Towels, Wash Cloths; and Kitchen Towels
 All personal bath items (i.e., shampoo, soap, toothpaste, hair dryers, etc.)
 All food items & condiments – this includes salt/pepper, ketchup, coffee (& coffee filters), etc.
 Dish Detergent - Dishwasher detergent and/or liquid dish soap (for hand-washing dishes)
 Trash bags

All purpose cleaning solution

Toilet Paper & Paper Towels
The Demory-Wortman House is equipped with the following:

We have (1) King, (1) Queen, and (6) Twin beds

Blankets, pillows (you must bring pillow cases if you plan to use our pillows)

Wi-Fi connection

Vacuum cleaner, broom, dust pan

Full-size refrigerator, Stove/oven, dishwasher, microwave, toaster, coffee pot

A number of plates, bowls, cups/glasses, mugs, silverware, cooking utensils; pots/pans, some bakeware and casserole dishes.
Remember to take all personal items with you when you leave.
Please do not leave ANY new, used, or leftover items that you brought with you (shampoo, food, condiments, etc.).
The refrigerator and freezer must be empty, and clean, before you leave.
(We will gladly accept donations of toilet paper, liquid soap, and paper towels.)
Absolutely No Animals Allowed in the Demory-Wortman House
Therefore, if you have reserved the Demory House, please do not bring any animals.
is a 501(c)3 non-profit organization.
BRCES Demory House Rental App, Page 2 of 6

Please print a copy of this checklist & bring with you.
Before departing, please complete this checklist (in its entirety), sign where indicated, & leave on table.
Your security deposit will be refunded if: all of the following checklist items have been met, no items are damaged or missing, this completed checklist has been received, and the facility passes inspection by authorized BRC staff member.

Wipe down kitchen countertops, tables, & appliances (refrigerator, stovetop, microwave, etc.).

Make sure oven (& all burners) are turned “OFF.” Unplug coffee maker(s), toaster, & microwave.

Wash all dishes/utensils and return to proper cabinet/drawer. (Or, if you run the dishwasher before you leave, you may leave the “ clean ” dishes in the dishwasher.)

Do a quick sweep/vacuum of floors.

TRASH & RECYCLING - Do not mix trash and recycling: o Make sure all trash cans and recycling bins are emptied. Tie up all trash bags and put
trash in BRCES dumpster, located behind main building (i.e., big barn with red roof). Do not leave any trash or trash bags outside at any time, as it attracts rodents and wildlife. o Collect all recycling in a separate trash bag. Tie up all recycling bags and leave next to
BRCES recycling bins, located in front of main building (i.e., big barn with red roof). Do not leave any recycling bags outside of Demory House at any time, as it attracts rodents & wildlife.

Take all food & condiments with you when you leave. Please do not leave any food/condiments behind, even if it has not been opened. This includes canned goods.
The refrigerator and freezer must be empty and clean before you leave .

Clean bathrooms before you leave and Take all personal belongings with you. o Please do not leave any leftover shampoo, etc. behind (even if it has never been opened).
( Exception : We will gladly accept donations of toilet paper, liquid soap, and paper towels.)

Leave all BRC comforters, blankets, & pillows on beds.

Turn off all lights (inside & out).

Leave the following items on the table ( next to Guest entrance door ): o guest Key o dirty/soiled BRC kitchen towels / pot holders o completed Checklist

Lock door behind you.
Signature:
Name (Please Print):
Address:
City:
Phone:
State:
Email:
Date:
Zip Code:
Please leave this form, guest key, & dirty BRC towels on table, & lock door as you leave.
BRCES Demory House Rental App, Page 3 of 6

Visitation and Land Use Policies
Statement of Philosophy:
The Blue Ridge Center is managed for its ecological and historical values. Our programs and activities are intended to protect the ecology of the area and the integrity of historical resources. The garden and agricultural areas are as important ecologically as the forest, meadows and streams. Failure to follow our land use policies could have immediate and devastating effects on the entire season's crop in our garden. In addition, there are rare and threatened flora and fauna present onsite.
All guests, volunteers, visitors, employees, vendors, and contractors are required to adhere to our policies.
Removing plants, artifacts or any property from the Blue Ridge Center is prohibited:
The Blue Ridge Center is an educational resource that is actively under study. Old bottles, plates and other remnants of former inhabitants must be left where they lay. If you see something that may be of interest to researchers, please let Blue Ridge Center staff members know where you saw it, but leave it alone. Similarly, please do not pick flowers or remove plants, feathers, nests, rocks, mushrooms, berries or other flora or fauna from the Blue Ridge
Center. This includes antlers, skulls and bones. Violators will be prosecuted to the fullest extent of the law.
Take only photos and leave only footprints.
Tobacco Use:
Smoking is prohibited within 100 yards of the garden fence, in the garden area itself, in any building, and is strongly discouraged in other areas of the Blue Ridge Center property. This policy is necessary to protect our garden from tobacco-borne viruses and bacteria, which are carried on the hands of smokers, as well as in tobacco smoke. These viruses and bacteria are particularly damaging to farms such as ours. If you must smoke onsite, please keep in mind our Leave No Trace policy. DO NOT throw cigarette butts on the ground; take them home with you and dispose of them properly.
Animals: NO Animals allowed at Demory House.
For visitors who are not staying at the Demory House, the following rules apply: No animals allowed in any BRCES building (with exception of working service animals). All dogs must remain on a leash at all times. (Dogs allowed to roam off leash will tend to depart from the established hiking trails, thereby encouraging erosion. Also, even a usually well-behaved dog may act unpredictably in the presence of wildlife or farm animals.) Be sure to clean up after your dog. Dog feces left on the ground can adversely affect water quality. No dogs (or people) allowed in any ponds or streams on the property.
Parking:
All vehicles must be parked in designated parking areas. Vehicles are not allowed to go past the trailhead to the Demory Field campground except by special permission from authorized
Blue Ridge Center staff members.
BRCES Demory House Rental App, Page 4 of 6

Group Hiking:

All groups must stay on established hiking trails. Bushwhacking across the preserve will not be allowed. Following game trails is prohibited.

All youth groups must be led by a minimum of two qualified adult leaders.

All group leaders should carry a cell phone and first-aid kit for emergency use.
Fires and Firewood:
Ground fires and wood gathering are not allowed. Ground fires can sterilize the soil and leave unsightly fire rings, scarred rocks and unburned wood. If you have reserved Demory Field, we have a fire ring for campfire use. You must bring your own ( local ) firewood. The gathering of dead and downed wood on Blue Ridge Center property is prohibited. When finished with your fire, burn all wood and coals to ash, put out the campfire completely, thoroughly soak with water, and then scatter the cold ashes.
Horses:
Only members of the United States Trail Ride, Inc (USTR) are permitted to ride horses on Blue Ridge Center property.
Guest riders are not allowed - no exceptions. Horses must stay on established trails that are maintained thoroughly and are marked for their use. On multi-use trails, hikers yield the right-of-way to horses. Hikers should stop and move their body and pets to the side of the trail and allow horses to pass. All riders must have their USTR member tag (visible) on their body or horse while on Blue Ridge Center property. For more info, please visit the USTR website, www.ustrailride.org.
Other:
No Hunting, Fireworks, Firearms, or Explosives - Visitors are not allowed to hunt or to use fireworks, firearms, or explosives. Our farmers raise sheep and other animals that are stressed by loud noises.
Bicycles, ATVs, and all other similar vehicles (4-wheelers, dirt bikes, etc.) are not permitted on
Blue Ridge Center property.
No fishing, swimming, ice skating, or boating permitted in any streams or ponds. No pets (or people) allowed in any streams or ponds.
Recreational drugs and illegal substances are not permitted at the Blue Ridge Center. One violation of this rule is grounds for instant dismissal, and proper legal authorities may be notified.
Certain areas at the Center are restricted from public access, including (but not limited to) the animal pastures, fenced gardens, farm machinery and equipment, private residences, seasonal intern housing, and staff offices. Please respect the privacy of these areas.
Emergency Information:

For emergencies, dial 911

Neersville Volunteer Fire & Rescue (located across the street), 11762 Harpers Ferry Rd,
540-668-6974

Animal Control: 703-777-0406

Game Warden: Rich Landers, 540-295-3258

Jefferson Urgent Care, 84 Somerset Blvd, Charles Town, WV, 304-728-8533
BRCES Demory House Rental App, Page 5 of 6

I NDEMNITY , R ELEASE OF L IABILITY AND
A CKNOWLEDGMENT OF A SSUMPTION OF R ISK
Please make copies of this form for all individuals in your group.
Leave all completed forms on the table at the Demory House before you leave .
.
I understand that, as a Visitor, participating in any activity(s) at the Blue Ridge Center
(including, but not limited to, hiking, camping, walking, running, bending, lifting, etc.) is entirely voluntary. I know and understand the risks and dangers involved in the above-named activities, and I know and understand that unanticipated dangers may arise. I hereby assume all responsibility and risk, and agree to release and waive all claims, causes of action, judgments, and expenses, including reasonable attorneys fees and costs, in connection with injuries or damage to persons or property sustained or incurred in connection with, or as a result of, my activities while visiting the Blue Ridge Center, and hereby agree to indemnify and hold the Blue Ridge Center, its staff, officers, directors, members, volunteers, and any others acting on behalf of the Blue Ridge Center, harmless in connection with any and all of the foregoing.
Participant Name ( Please Print )
Address
City
Email
State
Phone #’s
Zip
Signature of Participant* Date
*If participant is under 18 years of age, signature of parent or guardian is required.
I am the parent or legal guardian of the participant indicated above. I hereby give permission for my child to participate in this activity. I have read and understand the information included in this form, and agree to all provisions set forth herein.
Signature of Parent or Guardian Date
BRCES Demory House Rental App, Page 6 of 6