2011 Mare Information Sheet
THIS FORM MUST BE ON FILE IN OUR OFFICE PRIOR TO BOOKING THE MARE
INTO THE BREEDING SHED. NO EXCEPTIONS!!
STALLION: _____________________________________________
MARE OWNER INFORMATION
Please type or print the following information (as it should be reported to the Jockey Club):
Name: ________________________________________________________
Address _______________________________________________________
Phone #’s _______________________________Fax # ___________________
E-Mail _____________________________
Mare Information (Correct Spelling Needed)
Mare's Name __________________________Year ______Color_________
Mare's Sire ____________________________________
Mare's Dam ____________________Dam’s Sire ___________________
IMPORT STATUS: Is this mare an IMPORT for the 2011 Breeding Season?
( )NO ( )YES Import Date: _____________ Country of Origin:________________
Mare's Current Status:
( ) Maiden ( ) Barren ( ) Slipped
( ) In Foal ( ) Not Bred ( ) Foaled; Date ______Color ______ Colt/Filly
Stallion Bred To in 2010 _______________ Last Date Bred ______________
Mare's Produce History: Foaling Date Color Colt/Filly
Stallion Bred to in 2009________________ /10 ________ _________
Stallion Bred to in 2008 ________________ /09 ________ _________
Mare will board in Louisiana at ___________________________________
Farm Manager's Name ______________________Phone _______________
Fax ______________________ Cell _________________________
Do we have permission to tranquilize this mare if necessary. YES ( ) NO ( )
Mare's Veterinarian _______________________________Phone____________________
Signature _______________________________________Date_____________________
THIS FORM MUST BE ON FILE IN OUR OFFICE PRIOR TO BOOKING THE MARE
INTO THE BREEDING SHED. NO EXCEPTIONS!!
STALLION: _____________________________________________
MARE OWNER INFORMATION
Please type or print the following information (as it should be reported to the Jockey Club):
Name: ________________________________________________________
Address _______________________________________________________
Phone #’s _______________________________Fax # ___________________
E-Mail _____________________________
Mare Information (Correct Spelling Needed)
Mare's Name __________________________Year ______Color_________
Mare's Sire ____________________________________
Mare's Dam ____________________Dam’s Sire ___________________
IMPORT STATUS: Is this mare an IMPORT for the 2011 Breeding Season?
( )NO ( )YES Import Date: _____________ Country of Origin:________________
Mare's Current Status:
( ) Maiden ( ) Barren ( ) Slipped
( ) In Foal ( ) Not Bred ( ) Foaled; Date ______Color ______ Colt/Filly
Stallion Bred To in 2010 _______________ Last Date Bred ______________
Mare's Produce History: Foaling Date Color Colt/Filly
Stallion Bred to in 2009________________ /10 ________ _________
Stallion Bred to in 2008 ________________ /09 ________ _________
Mare will board in Louisiana at ___________________________________
Farm Manager's Name ______________________Phone _______________
Fax ______________________ Cell _________________________
Do we have permission to tranquilize this mare if necessary. YES ( ) NO ( )
Mare's Veterinarian _______________________________Phone____________________
Signature _______________________________________Date_____________________
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351 Avera Street
Sarepta, LA 71071
318-847-4800 office
318-578-1724 mobile
318-847-4170 home
Sarepta, LA 71071
318-847-4800 office
318-578-1724 mobile
318-847-4170 home