Registration Application - Tennessee Walking Horse Breeders` and

TWHBEA REGISTRATION APPLICATION/PARENTAGE VERIFICATION KIT REQUEST
Registration#
TENNESSEE WALKING HORSE BREEDERS’ & EXHIBITORS’ ASSOCIATION • P.O. BOX 286 • LEWISBURG, TN 37091-0286 • WWW.TWHBEA.COM
APPLICANTS MUST QUALIFY AS OFFSPRING OF THEIR SIRE & DAM. IF YOU HAVE QUESTIONS, PLEASE CONTACT CUSTOMER SERVICE, 931-359-1574.
INSTRUCTIONS ON REVERSE!
1
THIS IS A:
o Registration Application and
Parentage Verification
Kit Request
2
NAME CHOICES OF ANIMAL TO BE REGISTERED (List three choices; 25 character maximum)
OR REGISTERED NAME OF ANIMAL TO BE PARENTAGE VERIFIED (Enter name below on first line.)
(See reverse side for details)
5
Breeding Date
2nd choice
If pasture bred, enter dates mare was exposed:
From: ______/______/_______
3rd choice
To: ______/______/_______
Office Use
6
OFF (RIGHT) SIDE
4
FACE MARKINGS:
7
COLOR:
_______STOCKING_______
Mane/Tail Color Dilutions
o Dun
o Silver
__________SOCK__________
________FETLOCK_________
________CORONET_________
L
R
1
2
Fore Legs
R
4
L
3
Hinds Legs
modifiers Pattern*
Sabino
o Grey
o Roan o Overo
o Tobiano
o Tobiano/Sabino
Tovero
Describe facial markings:
Written description:
(1) Left Fore Leg: ___________________________________________________________________________________________________________________________________
(2) Right Fore Leg: ____________________________________________________________________________________________________________________________________
__________________________________________________________
TWHBEA USE ONLY:
__________________________________________________________
____________________________________________________________________________________________________________________________________
__________________________________________________________
(4) Right Hind Leg: ____________________________________________________________________________________________________________________________________
__________________________________________________________
8
Stallion
Mare
Gelding
Brown
Classic Bay Roan
Classic Blue Roan
Classic Sorrel Roan
Amber Champagne
Amber Cream Champagne
Classic Champagne
Classic Cream Champagne
Gold Champagne
Gold Cream Champagne
White (Max. Sabino)
Bay
Black
Chestnut
Sorrel
Buckskin
Cremello
Palomino
Perlino
Smoky Black
Smoky Cream
Upper Lip
Lower Lip
and Chin
L
R
1
2
Fore Legs
SEX:
o NONE
NEAR (LEFT) SIDE
Draw in every white area.
Indicate all dark spots
within white area.
(3) Left Hind Leg:
3A State Foaled In
Click to Clear
1st choice
BODY MARKINGS:
o NONE
R
L
4
3
Hinds Legs
BREEDING INFORMATION:
Foaling Date
(For an unregistered animal.)
o I would like to nominate this foal for
the TWHBEA National Futurity.
3
SIRE AND DAM:
Clear Owner Info
Sire’s Registered Name
Sire’s Registration Number
Sire’s Owner: X ______________________________________________________________________________________________________________________ AT TIME OF SERVICE, SIGNATURE REQUIRED.
Print Form
Dam’s Registered Name
Dam’s Registration Number
Dam’s Owner: ___________________________________________________________________________________________________________________________________________ AT TIME OF SERVICE, PRINTED NAME ONLY REQUIRED.
Dam’s Owner: X __________________________________________________________________________________________________________________________________________ AT FOALING TIME, SIGNATURE REQUIRED.
9
FEE SCHEDULE:
Registration Fee
______________
Printed Name: _________________________________________________________________________________________________ Email Address: ________________________________________________________________________________________
Parentage
Verification Fee
______________
Mailing Address: _______________________________________________________________________________________________
Other
______________
TOTAL ENCLOSED
______________
Home Telephone: (_________) __________________________________________________________________________
City/State/Zip: _________________________________________________________________________________________________ Cell Phone: (_________) _________________________________________________________________________________
© 2015 TWHBEA
10/15
INSTRUCTIONS
1
If this is an application for registration of an unregistered animal
and a parentage verification kit request, check the appropriate
box, and leave the registration # box in the upper left corner blank.
If the application for registration is for a foal that is to be shown
under halter prior to receipt of the official registration certificate, the
assigned name and assigned registration number (upper left hand
corner) as they appear on the copy of this form returned with the
parentage verification kit may be used for a period of six months
from the processing date.
If you checked the TWHBEA National Futurity nomination box call
TWHBEA at (931)359-1574 to make a Futurity payment.
1.) Sire Fee -- This is a one time fee for the particular foal crop
nominated. Sire Fee must be PAID for foal to be entered.
2.) Dam Fee -- A one time fee is good for the duration of foal’s
Futurity career.
3.) Foal Fee -- Foal nominated in year of foaling follows schedule 1.
2
NAME: If this is an application for registration, provide three
name choices in block #2. Names are limited to 25 characters
including spaces & apostrophes. Do not use the line for “office use.”
If this is a parentage verification kit request only, please enter the
registered name in the “first choice” space.
- Black, Modifier - Roan, Pattern - Sabino. May be applicable
depending on animal.
8
SIRE AND DAM: Supply complete, accurate information!
Carefully enter the registered names and numbers of both
the sire and dam in block #10. Obtain signatures of mare
owner at foaling time and stallion owner at time of service.
Print the name (signature not required) of mare owner at time
of service. (Not required if this is a parentage verification kit
request only.) When foal application is being used for a foal that
results from the use of retained frozen semen, the owner of the
semen will be allowed to sign for the breeding provided he/she
has filed a Retained Semen Disclosure Statement. In order for
the Association to accept the signature of anyone other than the
recorded stallion owner at the time of breeding, the Certificate
for Frozen Semen must be endorsed by the current owner of the
frozen semen. Print name, address and phone number of dam
owner.
9
FEE SCHEDULE: Consult the fee schedule at right and
enter appropriate fees in block #12
3
BREEDING INFORMATION: Enter exact date of foaling. Enter
date mare was bred. (For parentage verification request only, breeding date is not required.)
REGISTRATION REQUIREMENTS
3A
Any person or persons who shall willfully register or record a false
pedigree shall be forever barred from making further registrations and
the registration of such false pedigree shall be canceled.
Indication of the state in which a foal is born will allow
records to be kept that could be used in states where awards
are available through agricultural agencies. (Optional)
4
5
In block #4, indicate whether the animal to be registered and/or
parentage verified is a stallion, mare or gelding.
BODY MARKINGS: In block #6 outline, with dark solid lines, all
white markings of horse represented by this application, include
markings on sides of head and chin. If there are no markings, check
the box marked none.
6
FACE MARKINGS: Outline, with dark solid lines, all white on
face, lips and chin. Indicate dark spots within white areas. Give
written description as blaze, strip, star, snip or bald. If there are no
markings, check the box marked none.
7
COLOR: Choose one base body color. Then choose a dilution,
and/or modifier, and/or pattern as applicable. If the animal is
overo, sabino, tobiano, or tobiano/sabino, you must submit photographs showing front, back, and both sides of the animal. The application will be returned if this area is not completed. This will cause
a delay in processing your application. For example: Base body color
• Application for registration must be typed or in ink. This application
becomes an important part of the records of the Association. Every care
should be exercised in giving dates, markings, etc.
• All foals, in order to be registered, must be the progeny of a parentage
verified, TWHBEA registered stallion and mare.
• All foals must be parentage verified before a certificate of registration
will be issued.
• The recorded owner of the dam at time of foaling may transfer the
unregistered foal by completing a Transfer Report/Bill of Sale. The
appropriate fees (both transfer and registration) must accompany the
registration application. To transfer an unregistered foal, leave block #1
on the Transfer Report/Bill Of Sale blank, but complete block #2 which
asks for the year of foaling and the dam’s registration number.
• Mailing responsibility: TWHBEA takes no responsibility for the
certificates of registration once they are mailed to the owner. The person
applying for transfer or registration is soley responsible for the accuracy
of the mailing address. Certified mail or special delivery may
be requested by the applicant at his or her expense.
SCHEDULE OF FEES
TWHBEA Membership Options
Adults 18 or over may choose between annual dues which are $60 or lifetime memberships which are $1,000. Both include a subscription to the Voice
magazine.
Individuals under 18 may become a junior member for $10 annually and
conduct business at the reduced membership rate. However, junior memberships
do not include a subscription to the Voice.
Registration of Foals
(The fee, which must accompany application, is based on the date the
application is postmarked and the membership status of the owner of the mare
at the time of foaling.)
Foal Application*
Member
Non-Member
If registered: Within 6 months of
$ 40
$ 100
After 6 months, but within 12 months:
$ 70
$ 130
After 12 months, but within 24 months:
$ 130
$ 190
After 24 months, but within 36 months: $ 250
$ 310
After 36 months, but within 48 months:
$ 370
$ 430
After 48 months:
$500 members only
*To be registered, animals must be parentage verified.
**See special gelding incentive registration savings at www.twhbea.com
Transfer of Ownership
(The fee, which must accompany application, is based on the date the transfer
is postmarked and the membership status of the person making the transfer.
Seller(s) required to sign transfer and fill in date of purchase in his/her personal
handwriting.
Transfer Fee
Member
Non-Member
Within 30 days of purchase date:
$ 40
$ 100
After 30 days but within 120 days: $ 70
$ 130
After 120 days but within 180 days: $ 100
$ 160
After 6 months of purchase date:
$ 130
$ 190
Gelding Registration and Transfer
Member
Non-Member
If registered within 36 months of foaling:
$ 40
$ 100
If registered after 36 months:
$ 100
$ 160
Transfer Fee:
$ 20
$ 80
* To be registered, animals must be parentage verified. Parentage verification fees are
in addition to the registration fee. Blood typing or DNA will be accepted for geldings.
** Statement from the veterinarian or a person performing the castration must
accompany the application for registration, and no foals will be registered from this
gelding, no exceptions.
Other Services
Fees
Member
Non-Member
DNA kit:
$ 50
$ 110
Duplicate certificate of registration:
$ 75
$ 135
Alteration after certificate is issued: $ 20
$ 80
Name change (25 character limit including spaces):
Name of registered TWH may be changed provided it has not sired or produced
a registered foal.
$ 50
$ 110
Research (per hour, 1 hour min.) $ 100
$ 100
DNA Conversion
$ 40
$ 100
Microchip $ 10 $ 70
DNA replacement kit
$ 10
$ 10
Not In Order Fee
$ 20
$ 20
Stallion Breeding Report on time
$ 25
$ 100
Stallion Breeding Report late
$ 100
$ 160