LIVERY BOOKING FORM

Please use this form to book your horse into Brackenspa Stud Farm Livery

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

OWNER DETAILS

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Livery

Please state which livery package you would like

HORSE DETAILS

Name (passport & stable)

Passport Number

Breed

DOB

YYYY

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 horse(s) residency is Brackenspa Stud Farm)

HORSE MANAGEMENT AND LIVERY

Flu and Tet due date

YYYY

Date last wormed

YYYY

Date last farrier visit

YYYY

Is the horse insured?

Has the horse been ill / injured in the last 6 months

Date of arrival

YYYY

Planned duration of stay

Feed and care instructions

Relevant behavioral history

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

Refer to a hospital

DECLARATION

I have read and understood Brackenspa Stud Farms Price List and Terms and Conditions. By signing the booking from, I accept that additional costs may be incurred during the period my horse is at Brackenspa Stud Farm 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