Name of mare (required)

Owner

Address Line 1

Address Line 2

postcode

E-Mail Address

Telephone

Mobile

Height

Age

Breed/Type

Colour

By law the passport must accompany the mare to the stud or to the A.I centre/veterinary where A.I is taking place.

Passport Issuing Authority

Passport (Life Identity) Number

Please tick appropriate box and go to section stated.

MARES ATTENDING COUNTRY FARM STUD - GO TO SECTION A

ORDERING OF CHILLED SEMEN OR FROZEN SEMEN - GO TO SECTION B

Section A - Mares attending Country Farm Stud for cfs/walk in stallions or for A.I. to outside stallion

Stallion Name

If this is not a cfs or walk in stallion, please give the following details

Is the semen chilled or frozen?

Contact details for semen

Please email a copy of any ordering arrangements you have been given

Is the passport page signed ‘Not for human Consumption’ (We may not be able to use some fertility treatments if
this page is not signed)

Permission for the vet to sign if needed.

Last date the mare was in foal or due date in foal

CEM and EVA Certificates must accompany the mare to stud and must be current (after 1st Jan of the current
year). If tests are already completed please fill in below.

Dates of CEM tests

Date of EVA blood test

Date of last season (If known)

Is the mare

Last date the mare was in foal or due date if in foal

Please give any History of or issues with past coverings i.e. twin pregnancy fluid retention etc

Type of Livery

Is the mare vaccinated for Flu?

Is the mare vaccinated for Tetanus?

We recommend that all mares are vaccinated.

Permission to start tetanus course or give booster if due whilst at stud

Is she insured?

Sum Insured

Is she insured for vet fees?

insurance Company

Are they aware she is here?

Section B - Ordering of chilled or frozen semen

Stallion name

Type of semen required chilled/frozen

Please fill in the name & address of the Veterinary Surgeon who will be inseminating the mare. Please
note BEVA have an approved vets list for A.I practices

Postcode

Telephone

Mobile

Is the vet on the BEVA approved list for A.I?

If not going directly to the vet please state the address the semen is to be sent to including the post code

Current charges can be found in the Stud Brochures & on our website*

Privacy and GDPR
Your privacy is very important to us, in line with the new General Data Protection Regulation (GDPR) we will not
share your information to third parties except in order to carry out our services or to to run our business and care
for your horse. We may need to share your data with other parties such as but not exclusive to Veterinary
surgeons, Farrier, Physio, Passport agencies, Transport Companies, DEFFRA, Insurance Company, Legal entities
and Police, debt collection agencies.
I would like to receive ongoing news, offers by email from Country Farm Stud Ltd. , I understand I can opt out of
this at any time by requesting to be removed from the mailing list
I hereby state that I have received/downloaded & read the full Terms Conditions of Country Farm Stud Ltd, I agree
to abide by them & the above information I have given is correct to the best of my knowledge.

I agree to Country Farm Stud storing my data and sharing it with Bred Societies, Farriers and veterinary Surgeons
as needed to care for and register any of my animals. I agree to the ongoing storage of my and my animals’ data
for registration and pedigree purposes

Please confirm that you agree to our terms and conditions. You can read the terms and conditions by clicking on this link: Terms & Conditions

I agree