Please Complete form on Page 2 and Send to: Larundel Warmblood Stud, 92 Lockes Lane. BELLI PARK Qld 4562 Australia or Email :firstname.lastname@example.org Fax: (07) 54470 450 For
LARUNDEL WARMBLOOD HORSES
LARUNDEL GANDALF (LFG)
The stud will make every effort to deliver the semen on the required day. However, no responsibility can be accepted for unforeseen delays. The mare owner is responsible for the payment of the transport of the shipper.
NOMINATION AGREEMENT FOR
I (name) agree to take a nomination to the Stallion
(Stallion name) ..for the season 200 .
SERVICE FEE $ (as Advertised)
I agree to pay a non refundable deposit of $100.00 (part of service and booking fee) for the above Stallion and all other fees as per the terms a conditions above as read and understood.
MARE DETAILS (To be completed by owner or veterinarian)
MARE (Name) AGE: .HEIGHT ..
Please answer the following:
Was the mare bred last year? .Maiden mare:
Any prior retained placenta? ..Caslicks done? .
Any prior abortion? .Reason if known .
Any prior fetal loss? At what age? ...
Any past uterine infection? .
Foaling difficulty or damage? .
Is the mare barren / In foal / Foal at foot ..DOB/Due .
Does your mare cycle regularly? ..When is she next due? ./ ./ ..
Last three breedings were ../ / .
Last three years foaled were ./ / ..
Please include the following documents for Barren Mares or Maiden Mares over 12 years old.
Current Uterine Culture, Cystology, Uterine biopsy results (if done)
Any other relevant informantion (attach details)
ADDRESS: PC .
Ph: (ah) Ph: (bh) ..Fax: ..
Complete for shipped semen only:
Veterinary Surgeon: .
Contact Details: Ph: Fax: Mob: Email: ...
I (print name) .agree to pay an extra fee for shipping costs and equitainer/cryogenic tank hire (deposit refunded on return) as well as all veterinary expenses relating to the collection of semen for each collection made and sent.
I have read and agree with the terms and conditions .
SIGNATURE .DATE: ..