Leisure Horse Ireland
Transcription
Leisure Horse Ireland
Leisure Horse Ireland www.lhi.ie Furbo Hill, Spiddal, Co. Galway, Ireland Tel. +353 (0) 91 577 577 Fax. + 353 (0) 91 670 111 Email. info@lhi.ie The Irish Piebald & Skewbald Studbook Stallion Registration Form (All sections must be completed in Block Capitals only please) OWNER NAME & ADDRESS NAME OF ANIMAL (ALL ANIMALS MUST BE NAMED) st Name: 1 Choice: Address: 2 Choice: nd rd 3 Choice: Tel. No.: Microchip No: Email: Equine Premises No: Year Foaled: __________________ Country of Origin: ____________________ (Age of stock taken from Jan 1st in any year) Is The Horse / Pony Registered With Any Or Another Society? If Yes: Society: _____________________________ Colour: (please√ as appropriate) Piebald Skewbald Other YES NO Reg. No.: ____________ __________________ Note / Colour: • • Piebalds are black and white only. Any brown markings particularly on the muzzle or under the belly will mean the horse is dark brown and it should be registered as a skewbald. Skewbalds are any other colour and white. e.g. Bay chestnut, Dark Roan and Palomino etc, with white. The white markings must be on the main body and / or neck and not just in isolation on the mane, tail, legs, and face or underneath the belly. (Stallion Registration) All Irish Piebald & Skewbald Studbook stallions 3 years old and over must be registered & licensed as such with Leisure Horse Ireland. An annual licensing fee will apply thereafter. Please contact Claire Flaherty for full details. Note / Breeding: • • Breeding Details: All Piebalds and Skewbalds can be registered whether or not their breeding is known. If breeding is known, then Verified Parentage papers will be issued if leisure Horse Ireland receives proof of parentage. See the Registration Checklist Below If breeding is known further back than Grand Sire please list on separate piece of paper. LHI Form 9 – Rev 5 – Mar ’14 – P1 Breeders Details: (please√ as appropriate) Unknown Details Below Name: _________________________ Address: _____________________________ ____________________________________________________________________ Sire: Breed Society Registration Number Gr. Sire Breed Society Registration Number Gr. Dam Breed Society Registration Number Dam: Breed Society Registration Number Gr.Sire Breed Society Registration Number Gr. Dam Breed Society Registration Number Check List: • • • • • • • The Marking Chart completed (if previously unregistered), stamped & microchip implanted etc by your Vet. Completed Veterinary Examination. DNA taken if required. This completed application form with all necessary sections completed. For verified parentage you must enclose with this application form: Dna SAMPLE and Mares Passport. The Balance of any fees due. Recorded return delivery (highly advisable as risk of loss in standard post lies with you) IRL € 10.00 UK €16.00 Fees: Stallion Registration Fee Contact Office I enclose the balance of fees due of €_________ cheques etc, made payable to Leisure Horse Ireland We accept please telephone 091 577 577 to make payment (intl tel +35391577577). I HEREBY CERTIFY THAT THE ABOVE PARTICULARS ARE CORRECT TO THE BEST OF MY KNOWLEDGE AND I AGREE TO ABIDE BY THE RULES OF THE IRISH PIEBALD & SKEWBALD STUDBOOK. Signed: ______________________________________________ Send All Documentation To: Date: _________________________ Leisure Horse Ireland, Furbo Hill, Spiddal, Co. Galway. LHI Form 9 – Rev 5 – Mar ’14 – P2 Leisure Horse Ireland www.lhi.ie Furbo Hill, Spiddal, Co. Galway, Ireland Tel. +353 (0) 91 577 577 Fax. + 353 (0) 91 670 111 Email. info@lhi.ie The Irish Piebald & Skewbald Studbook VETERINARY EXAMINATION OF STALLIONS VETERINARY REPORT TO BE COMPLETED IN FULL BY A VETERINARY SURGEON Name of Stallion ____________________ Year of Birth _______ Microchip No. __________________________Height________ Heart: Normal Eyes: Normal □ Abnormal □ Remarks: _____________________________________________________________________ □ Abnormal □ Remarks: ______________________________________________________________________ Mouth: Normal □ Abnormal □ Remarks: ____________________________________________________________________ Examination of Genitalia: Normal □ Abnormal □ Remarks: _____________________________________________________ Limbs including feet: examination for ringbone, sidebone, bone spavin, curbs, etc. Allowance should be made for obvious injury Left fore __________________________________________________________________ Right fore _________________________________________________________________ Left hind __________________________________________________________________ Right hind ________________________________________________________________ Movement: evidence of lameness (give reason) ________________________________________________________________ Evidence of shivering, stringhalt or wobbler syndrome: remarks ______________________________________________________________________________________________________ Lunging and Endoscopic examinations must be carried out. Lunging (WIND): Normal □ Abnormal □ Remarks: ________________________________________________ Endoscopic Examination: Normal □ Abnormal □ Remarks: ___________________________________________ Upon completion of the above certificate it is also required that you: • • • Complete the marking chart provided Implant the microchip provided Take a hair sample and complete the DNA typing form provided N.B. Description Should Be Typed Or Written In Block Capitals ________________________________ Signature & Stamp Of Veterinary Surgeon / Signature Et Cachet Du Veterinaire Agree Vet Ref No. / Not To Be The Owner Or Trainer ________________________________ Place & Date (Lieu Et Date) LHI Form 9 – Rev 5 – Mar ’14 – P3 Section I B Leisure Horse Ireland Equine Identification Register Irish Piebald & Skewbald Studbook Irish Donkey Studbook *Indicate Microchip Location with “M” Neck Lower View (Encolure Vue Inférieure) Species: Equine Colour (Robe): Upper Eye Level (Ligne Supérieure Des Yeux) Right Side (Coté Droit) Muzzle (Nez) Left (Gauche) Right (Droit) Forelegs Rear View (Antérieurs Vue Postérieure) Asinine Sex (Sexe): Year (Anne): / / Marking Chart (Signalement Graphique) Left Side (Coté Gauche) Height (Hauteur): Left (Gauche) Right (Droit) Hindlegs Rear View (Postérieurs Vue Postérieure) New Microchip No. Barcode – Type/ Handwrite if one already present: (Micro Plaquette) cms Microchip Location Description: Head (Tete) Neck (Encolure) Limbs (Jambes) Left Foreleg (Ant G) Right Foreleg (Ant D) Description Should Be Typed Or Written In Block Capitals – See Also Note Below ______________________________ Signature & Stamp Of Qualified Veterinary Surgeon Only (Not To Be The Owner Or Trainer) Signature Et Cachet Du Veterinaire Agree Left Hindleg (Post G) Right Hindleg (Post D) Body (Corps) Vet Ref No.: ________/___________ Place & Date (Lieu Et Date) Acquired Marks (Marques Acquises) Note: Veterinary Surgeon Obligations • You must ensure that the markings and written description agree (white markings drawn in red). • Please also ensure that you sign, date, note place of marking, clearly apply your official stamp and VCI Ref. • It is further understood that you are hereby verifying the Colour, Sex, Age, and Height (if applicable) of the animal and that by applying a new bar code de la label for the compliant microchip you have implanted and location tion noted, you have thoroughly checked that no microchip was implanted previously. LHI Form 9 – Rev 5 – Mar ’14 – P4