MARE FOALING DOWN BOOKING FORM

Please use this form to book your pregnant mare foaling down at Brackenspa Stud Farm

This form must be completed IN FULL before the mare arrives at Brackenspa Stud.

OWNER DETAILS

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

HORSE DETAILS

Name (passport & stable)

Passport Number

Breed

DOB

YYYY

Relevant Breeding History

(especially previous year)

Relevant Medical History

Usual Vet Practice

including vet(s) name and number (If your horse is insured, ensure the insurance company have been advised of your horses residency and foaling work at Brackenspa Stud Farm)

PREGNANCY DETAILS

Sire

Dam

Last Covering Date / Ovulation Date

YYYY

Due Date (if known)

YYYY

Insured

Date of EHV vaccination dates

list all 3 dates

Rotavirus Vaccination Dates

(list all 3 dates)

FOALING DOWN

Is the owner happy for Brackenspa Stud to assist with foaling down as necessary

Is the pregnancy insured?

Will the foal be insured?

We will always try to save both mare and foal but in the unfortunate circumstances where a choice needs to be made, who has priority

Do you wish to be contacted at any time (including middle of the night) in case of an emergency?

Add any additional emergency contact numbers

(###)

###

####

IF UNREACHABLE OR YOU DO NOT WISH TO BE CONTACTED, DO YOU GIVE US PERMISSION TO

Call an on-call vet

Perform an assisted vaginal delivery, inc. general anaestheia

Refer to a hospital eg. for a caesarean

Mares are bought into stables at night prior to foaling & the mare and foal may continue this livery for a time, extra livery charges may apply during this time.

MARE MANAGEMENT AND LIVERY

Please complete the following section if your horse is stay at the stud

Flu and Tet due date

YYYY

Date last wormed

YYYY

Date last farrier visit

YYYY

Has the mare been ill in the last 6 months

Date of arrival

YYYY

Planned duration of stay

Livery

Feed and care instructions

DECLARATION

I have read and understood Brackenspa Stud Farms Price List and Terms and Conditions. I agree that my horse has been signed out of the Foodchain. By signing the booking from, I accept that additional costs may be incurred during the breeding works over and above the detailed package costs. Please ensure you notify us should you have a specific budget cap you do not want exceeding. I consent to images of my horse(s) being used for marketing

Signed

Name

Date

YYYY

I consent to images of my horses to be used for marketing purposes