Horses Name

Breed

Gender

Age

Brand ID

Value

Desription

Owners name

Phone

Email Address

I hereby confirm that I am the owner/or person responsible for the afore mentioned horse and give consent for this horse to be handled, started under saddle, schooled, transported, boarded, cared for and receive first aid and health care as deemed necessary by Mel Fleming and staff. I hereby confirm that I hand the horse over in good condition and that, to the best of my knowledge, the horse has no known health or psychological problems, other than those which have been identified to the Trainer below.

Know Allergies to Food or Drugs

Other requirements or known health, psychological or behavioural problems

I find the facilities and staff for the care and training of the horse to be acceptable and I am satisfied with the arrangements for the daily routine and care of the horse including stalling and turnout. I am satisfied that the Trainer has the best interests of the health and welfare of the horse uppermost and agree that the Trainer has the right to adjust the routine of the horse as it has been shown to me if the trainer believes that the continuing practice may prejudice the welfare of the horse: such adjustments include change of feeding regime, rugging, additional rest periods for horses, or paddock/ living area adjustments. In the event of sickness or injury to the horse, I consent to immediate call-out of a veterinarian (at my expense) if the Trainer deems it appropriate. The Trainer hereby also confirms that he/she will use the best endeavors possible to notify the Owner of any sickness or injury of the horse as soon as it is practical.

I HAVE CAREFULLY READ THIS AGREEMENT AND FULLY UNDERSTAND ITS CONTENTS. I AM AWARE THAT THIS IS A CONTRACT BETWEEN MYSELF AND THE TRAINER AND I AGREE THAT I SIGN OF MY OWN FREE WILL AND THAT THIS AGREEMENT WILL BIND ME, MY LEGAL REPRESENTATIVES, DISTRIBUTEES, GUARDIANS, ASSIGNS, HEIRS AND NEXT OF KIN AND THAT IT MAY BE PLEADED IN BAR TO ANY LEGAL ACTION COMMENCED IN ANY COURT CONTRARY TO THE TERMS HEREOF.

Release and Indemnity Release and Indemnity I have Read and Agree to the Release and Indemnity

Permission to photograph and video Permission to photograph and video I have Read and Agree to the media release for video photographs

Comments, questions or message to trainer

Signed

Date