Hurstland
Farm, Inc.
859.846.4435 Office
484 Spring
Station Rd.
859.846.4436 Fax
PO Box 305
859.221.4435
Alfred Nuckols’ cell.
Midway KY
40347-0305
e-mail to: hurstlan@iglou.com
STALLION: __________________________
SHARE # (if known):
____________
MARE
OWNER: ____________________________________________________________
As it should be reported to The Jockey Club
______________________________________________________________________________________
Address (Street/PO Box, City, State Zip)
Telephone: ________________ Fax: ___________________ E-mail: ____________________
MARE:
____________________
YOB: _____
COLOR: _____
(#: _________)
Sire:
____________________
Dam:
_________________ Dam’s
Sire: ________________
Mare’s current status:
Pregnant ____
Not Pregnant ____ Maiden
____ Aborted ____
Not mated _____ -or-
Mare’s 2006 produce (if applicable): Foaling date: _________ Sex: ______ Color: _______
Stallion bred to in 2005: ____________________________ Last Breeding Date: _______________, 2005
IMPORT
STATUS:
Is this Mare an Import for the 2006 Breeding Season?
NO ____
YES ____ Import
Date: ____________
Country of Origin: ________________
MARE’S 2006 BOARDING FARM: ___________________________ Farm phone: _______________
Farm Manager or contact:
_____________________________________
Farm Fax: _________________
MARE’S RECENT PRODUCE
YEAR FOALED
SIRE
DATE FOALED
COLOR
AND SEX OF FOAL
2005
__________________________________________________________________________
2004
__________________________________________________________________________
2003
__________________________________________________________________________
Please
include any comments that could be of benefit to the Breeding Shed crew as
regards your Mare.
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
Signature
of Owner or Authorized Agent
______________________________________
Date ___________
This Form must be on file in our office before the Mare can be booked or covered.