Page 1 of 2 SOUTHEASTERN HORSE SALE ENTRY FORM CONSIGNMENT INFORMATION OWNER________________________________________________________________________ ADDRESS______________________________________ CITY____________________________________ ADDRESS______________________________________ STATE__________ ZIP______________ CELL PHONE___________________________________ OTHER PHONE___________________________ EMAIL ADDRESS___________________________________________________________ AGENT (IF ANY)__________________________________________________________________ ADDRESS______________________________________ CITY____________________________________ ADDRESS______________________________________ STATE__________ ZIP______________ CELL PHONE___________________________________ OTHER PHONE___________________________ EMAIL ADDRESS______________________________________________________________________ NAME OF HORSE_____________________________________REG NO_____________________ CHECK ONE: AMERICAN SADDLEBRED___________HACKNEY___________ROADSTER____________ MORGAN___________OTHER_____________ CHECK ONE: FIVE GAITED________THREEGAITED__________FINE HARNESS___________ PARK__________PLEASURE___________EQUITATION_________ROADSTER__________ BROODMARE____________BROODMARE & FOAL_________TWO YEAR OLD__________ YEARLING__________WEANLING_______HACKNEYHARNESS________HACKNEY_______OTHER____ DATE OF BIRTH_______SEX________COLOR___________HEIGHT_____________ MARKINGS________________________________________________________________________ BREEDER_________________________________CITY_______________________STATE______
Page 2 of 2 NAME OF HORSE_____________________________________REG NO_____________________ PEDIGREE (A COPY OF REGISTRATION PAPERS IS REQUIRED) SIRE____________________________________________ SIRE'S DAM______________________________________ BY_____________________________________________ 1ST DAM_________________________________________ BY_____________________________________________ 2ND DAM_________________________________________ BY_____________________________________________ 3RD DAM_________________________________________ BY_____________________________________________
OWNER'S STATEMENT (SUBJECT TO EDITING BY SOUTHEASTERN HORSE SALE STAFF) ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ FOR BROODMARES, ENTRY HAS BEEN PRONOUNCED IN FOAL______HAS BEEN BRED______NEITHER_____ BRED TO (STALLION)___________________________________________ LAST BREEDING DATE_______________ ENGAGEMENTS (ANY SWEEPSTAKES, FUTURITIES, GRAND NATIONAL OR OTHER PROGAMS FOR WHICH ENTRY IS ELIGIBLE)_______________________________________________________________________ I HAVE READ, UNDERSTOOD, AND AGREE TO ALL TERMS AND CONDITIONS OF THE SOUTHEASTERN HORSE SALE CONSIGNMENT CONTRACT. I HEREBY ATTEST THAT ALL INFORMATION LISTED ABOVE IS TRUTHFUL AND COMPLETE TO THE BEST OF MY KNOWLEDGE. SIGNATURE OF OWNER OR OWNER'S AGENT__________________________________________
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