| Hurstland Farm 'A Good Farm to Know' |
| Hurstland Farm, Inc. 484 Spring Station Road, P.O. Box 305 Midway, Kentucky 40347 Phone: (859) 846-4435 Cell: (859) 221-4435 Fax: (859) 846-4436 E-mail: hurstlan@iglou.com Website: www.hurstland.com 2010 MARE INFORMATION SHEET (This form MUST be on file prior to your mare being booked or covered) Stallion_____________________________________________ Mare Owner Information (Please indicate the way you wish the Mare Owner to be reported to The Jockey Club) Name________________________________________________________________________ Phone________________________ Address_____________________________________________________________________________________________________ Fax___________________________ Cell__________________________ E-mail________________________________________ Mare Information Mare’s Name________________________________________________________ YOB___________ Color__________________ Sire__________________________________________________ Dam_________________________________________________ Dam’s Sire_______________________________________________________ (Farm ID #________________________________) For office use only Mare’s Produce Record Mare’s status (please check one): In foal or has foaled for 2010 [ ] Barren [ ] Aborted [ ] Maiden [ ] Not bred in 2009 [ ] If mare was bred in 2009: Stallion mated to________________________________________ Last date bred___________________ If mare has already foaled in 2010: Foaling date___________________________ Color & sex of foal__________________________ 2009 Final Status or Sire of Foal___________________________________ DOB____________ Color/Sex_________________ 2008 Final Status or Sire of Foal___________________________________ DOB_____________ Color/Sex_________________ IMPORT STATUS: If this mare is an Import for the 2010 season: Import Date__________ Country of origin_______________ Mare’s Boarding Farm during Breeding Season Farm Name____________________________________________________ Contact Person________________________________ Phone________________________________ Cell_______________________________ Fax_______________________________ Name of Farm Veterinarian_______________________________________ Veterinarian’s Phone____________________________ PLEASE NOTE FOR 2010: Due to outbreaks of Equine Herpes Virus at racetracks and training centers our veterinarian has asked that we require all mares coming to the breeding shed be vaccinated for Equine Herpes Virus Type-1 (i.e. Rhinomune, Pneumobort K, etc.) from 7 – 90 days before breeding. A statement from your veterinarian to this effect must accompany the mare to the breeding shed (it may be on the culture certificate). |
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