PEMBERS HILL STUD FARM Mortimers Lane, Fair Oak, Eastleigh, Hampshire,SO50 7EA Tel: 02380 692354 Fax: 02380 696182 Mare Booking Form ............................................................................................agree to take a nomination to STALLION................................................................................................................................. For the season 2010. Stallion owner.......................................................................................................................................... Fresh semen: Chilled semen: Frozen semen: Arrival date................................................................................................................................... Mares name................................................................................................................................ Stallion Owner Colour.................................Height............................................Age............................................. Mare’s current record: Barren / Maiden / Foal at Foot / In foal Date of foaling/ due date......................Foal by/in foal to...............................Foal: colt / filly Breeding History............................................................................................................................. Dates of last vaccinations: Tetanus:................Influenza..................Rhinopneumonitis........................... Date of last Cervical Swab........................................................................................................................ Is the mare covered by a current Comprehensive Insurance Policy?.................................................... Type of livery: Grass: walker Stabled: Stabled and grass: Stabled & individual paddock/ horse Hard feed if applicable (stabled mares only) – what feed....................................................................... Worming: Next due date: Mare........................................Foal............................................................. Name of Owner..................................................................................................................................... Address................................................................................................................................................. ...................................................................................................Post code............................................ Telephone No: Day.........................................................Evening............................................................. I have completed the above agreement to the best of my knowledge and have read and agree to the terms and conditions offered by Pembers Hill Stud Farm Ltd. Signature...............................................................................Date.........................................................