BOARDING AGREEMENT. Name: % of Ownership Interest in Horse. Address: County. City State Zip Code. Work Phone: Home Phone: Cell Phone:

Transcription

1 FIRE STABLES, L.L.C. d/b/a PEEPER RANCH 9100 Cedar Niles road Lenexa, KS (the Premises ) Phone: Telefax: teresa.beers@peeperranch.com Web Page: BOARDING AGREEMENT THIS AGREEMENT ( Agreement ) is made by and between Fire Stables, L.L.C., d/b/a Peeper Ranch (hereinafter STABLE ), and OWNER, as identified in (1) below. 1. OWNER: (If a minor, list parents as owner here and identify minor owner information on Exhibit A. If multiple parties carry an ownership interest in Horse, please complete Section 3 below and identify ALL such owners on Exhibit A.) Name: % of Ownership Interest in Horse Address: County City State Zip Code Work Phone: Home Phone: Cell Phone: Social Security and/or Federal Tax # 2. HORSE:

2 Name Breed Registration Number Foaled Age: Sex Color Markings 1. MULTIPLE OWNERSHIP: OWNER certifies that OWNER: ( ) has sole title and registration to horse. ( ) has purchased the Horse on installment contract with final payment due original owner, identified on Exhibit A, on. Verbal Contract Written Contract. Attach copy of written contract. ( ) leases the Horse from Original Owner identified on Exhibit A - Verbal Contract Written Contract (Attach copy of written lease contract). ( ) manages the Horse for Original Owner identified on Exhibit A. Verbal Contract. Written Contract (Attach copy of written management contract). ( ) is one of several joint co-owners, as identified on Exhibit A. Owner of the horse as it appears on the registration certificate: Name Phone Number Address City State Zip Code (For additional owners, please complete on Exhibit A, incorporated by reference herein.) 4. OWNER WARRANTIES: OWNER warrants that the Horse is owned solely by OWNER, or, if others hold an ownership interest, that all such additional persons with ownership interests have been identified by name, address, phone number and ownership interest on Exhibit A to this Agreement. OWNER further warrants that OWNER above has been designated agent for and been given full authority by any and all other persons holding an ownership interest in the Horse to make all binding decisions regarding the Horse under this Agreement. 2. TERM. The term of this Agreement shall commence as of ( Commencement ) and, unless sooner terminated under the terms of this Agreement, continue thereafter on a month to month basis. Rental Period, for purposes of this term, means from the 1 st to the last day of the month..

3 6. BOARDING FEE is: a. Base Fee: The initial base Boarding Fee, excluding special services itemized on STABLE s Fee Schedule, $ per day. This fee includes: Large stall assigned at STABLE s discretion; water, grain two times per day, hay three times per day; and daily stall cleaning. Pasture board. Supplemental hay provided when required, at STABLE s discretion. a. Supplemental Services. Additional services must be separately contracted with STABLE per the STABLE s Fee Schedule. Monthly charges for supplemental services, including training and show fees (if applicable), will be added to Owner s monthly bill and will be considered as part of the overall fees due and payable under this Agreement per Section 8 of this Agreement. b. Stall or Pasture Location. STABLE reserves the right to temporarily relocate any horse on the basis of the horse s health, safety and welfare and/or the health, safety and welfare of other horses in this STABLE. Permanent relocations will be negotiated with the Owner. c. Price Adjustment. The price of monthly board and/or services provided on the STABLE s fee schedule may be adjusted at any time by STABLE, at STABLE s sole discretion, based upon thirty (30) days prior written notice. Notice shall be deemed given when so posted on either the STABLE s web page, in the STABLE lounge, and/or provided to OWNER in the prior month s billing statement. e. Payment Due and Late Charges: The Boarding Fee as well as payment for additional services, if applicable, shall be due and payable the 15th day of the month in which the Horse is being boarded, or on a pro rata basis, using a thirty (30) day month, if the Horse is brought to the STABLE after the 1 st day of the month. If accrued fees are not paid by the 5 th day after payment is due, a late fee of $25.00 will be assessed against OWNER. In addition, interest shall accrue on all outstanding balances owed to STABLE at a rate of 1.5% of the unpaid balance or $25.00, whichever is greater, per month until paid in full. In the event Owner s payment check is returned by the bank for insufficient funds, Owner will additionally be required to pay a $30 bad check charge. A bank return of two or more such checks shall be considered a material breach for non-payment of fees due under this Agreement. 7. STABLE PREMISES. STABLE agrees to board the Horse at 9100 Cedar Niles Road, Lenexa, Kansas (the Premises ). 8. BOARDING / LESSON / TRAINING OPTIONS. STABLE provides instructors and trainers capable of working with Owners and their horses for either pleasure or competition purposes. Should you desire lessons for yourself, or training services for your horse, said services are provided at the rates posted on STABLE s Fee Schedule. Other services provided in connection with shows and/or competitions shall be at an additional charge subject to the STABLE s fee schedule and shall be included on OWNER s monthly bill as incurred. If Owner desires either Lessons or Training, Owner is to arrange these services directly with STABLE. OWNER understands that STABLE and STABLE s TRAINERS/ INSTRUCTORS will utilize good faith efforts under industry standards to accomplish Owners objectives regarding lessons and training. However, STABLE gives no warranty or guarantee that desired results will be accomplished, given the many objective and subjective factors that can affect a horse and rider s performance. Supplements and medications reasonably necessary for the maximum competitive readiness of the horse will be provided to all horses in the STABLE s training program, as determined in the sole discretion of the STABLE. Said supplements and medications will be billed to OWNER in the monthly billing statements.

4 9. GROOMING AND EXERCISE. Unless otherwise arranged as supplemental services, OWNER is solely responsible for the grooming, exercise and condition of Horse. Should STABLE note that any horse is not being provided with adequate grooming, exercise and/or conditioning by its Owner, STABLE shall exercise its right, in STABLE s sole discretion, to provide such necessary services as are reasonably necessary for the horse s health, at OWNER s cost, or in the alternative to request immediate termination of this Agreement and OWNER s removal of horse from premises following payment in full of outstanding balances. 10. VACCINATIONS, DISEASE AND/OR ILLNESS. OWNER warrants that the Horse is free of all communicable diseases upon delivery to STABLE. STABLE may, at its option, require OWNER to provide, on or prior to the Horse s arrival on the Premises, a current health certificate including a record of all current vaccinations including, but not limited to, Equine Influenza, Tetanus, Sleeping Sickness, Rabies and West Nile, as well as a current negative Coggins test. If the OWNER fails to provide a record of current vaccinations and a Coggins test upon request by the STABLE, STABLE may, at its option, refuse acceptance of the Horse on delivery or, in the alternative, quarantine the Horse while securing a veterinarian exam and vaccinations and Coggins, at OWNER s expense. If at any time the OWNER fails to keep the Horse current on vaccinations, or in the alternative fails to provide STABLE with documentation verifying that all such vaccinations are current, then STABLE shall have the right to secure the required vaccinations, at the OWNER s expense. OWNER agrees that STABLE shall not be responsible for any disease, illness or injury which the Horse may contract or sustain while on the Premises. 11. EMERGENCY TREATMENT. (a) If the Horse contracts a disease or illness, or is injured during the course of its stay on the Premises which, in the reasonable opinion of STABLE, requires emergency treatment, STABLE agrees to employ reasonable attempts based upon the circumstances to contact OWNER prior to securing said treatment. OWNER agrees that if STABLE is unable to contact OWNER within a reasonable period of time, STABLE shall secure such emergency veterinary, farrier or other treatment deemed reasonably necessary by STABLE for the health and well-being of said Horse, including surgery. OWNER agrees that all costs of such care secured by STABLE shall be the responsibility of OWNER and may be direct-billed by Care Provider to Owner, or in the alternative prepaid by STABLE with reimbursement due directly on demand by STABLE. (b) Special Instructions. OWNER may additionally list the following special instructions concerning emergency medical treatment for OWNER S Horse: If any of the terms of this Section 11(b) conflict with Section 11(a) above, Section 11(a) shall govern. (c) Does OWNER currently have Horse insured (select one)? [ ] Yes [ ] No If Yes:

5 Name of Major Medical Insurance Carrier Policy# Policy Limits Expiration Insurance Carrier Contact Insurance Carrier Phone Number Name of Mortality Insurance Carrier: Policy# Policy Limits Expiration Insurance Carrier Contact Insurance Carrier Phone Number OWNER IS REQUIRED TO PROVIDE STABLE WITH INSURER S EMERGENCY NOTICE PROCEDURES AND CONTACT INFORMATION IN A FORMAT CAPABLE OF BEING POSTED ON THE HORSE S STALL. 12. OTHER INSURANCES. OWNER is solely responsible for, and strongly encouraged by STABLE to maintain any and all insurance coverages necessary for protection of OWNER s interests, including but not limited to the following as based on specific terms of the policy: A. Equine Liability/accident/injury: Covers OWNER s potential individual liability to third parties which arises out of OWNER s equine activities B. Equine Care, Custody and Control: Covers OWNER s potential liability if a horse OWNER is hauling or holding or is otherwise under OWNER s care is injured in any way C. Major medical: Covers medicals costs and care for OWNER s insured horse D. Mortality: Covers the fair market value of OWNER s horse in the event of its death per policy terms and exclusions. OWNER fully understands while STABLE may carry various insurance coverages, those coverages do not necessarily provide full protection to OWNER. OWNER is solely responsible for obtaining any and all insurance required to cover OWNER s risks, including damage or loss of personal property stored on the Premises, including but not limited to the horse, tack, carts, trailers and vehicles. In addition, should OWNER trailer horses owned by others to off-site locations, OWNER is strongly encouraged by STABLE to secure Care, Custody and Control insurance. OWNER is strongly encouraged to additionally consult with OWNER s homeowner s agent as well as an equine insurance specialist to determine what coverages OWNER needs to adequately protect OWNER's interests for all of OWNER s equine activities.

6 13. TEMPORARY OR PERMANENT REMOVAL OF HORSE. If the Horse is to be removed from the property, either temporarily or permanently, (including an off-site trail ride, competition attendance, etc), OWNER shall so notify STABLE. These requirements serve two purposes: a. It advises STABLE if the Horse is to be offpremises and also alerts STABLE to enable followup for OWNER and Horse s safety and wellbeing if the Horse is not returned when reasonably expected; and b. It prevents the release of horse by STABLE to an unauthorized person. OWNER shall contact STABLE at the phone number above, or in such other manner as is mutually acceptable to STABLE to arrange any releases of the horse from STABLE premises. OWNER is solely responsible for determining whether the Horse is sufficiently healthy to be moved, and for obtaining any necessary blood test, vaccinations, and health certificates, whether through STABLE s veterinarians or otherwise, if required, and therefore OWNER shall assume full responsibility for, and releases STABLE from, any responsibility or liability for the Horse s health, soundness, and condition prior to or at the time of release. Should OWNER desire that STABLE release the Horse or any other property stored on the Premises to any third party, OWNER must provide to STABLE his or her written consent to such release before STABLE will give possession of the Horse or such other property to the third party. Such third party must provide acceptable identification before the Horse or such other property will be released to the third party. If OWNER fails to provide the release notice required by this paragraph, STABLE will not release the horse. Similarly, if Horse is owned by multiple OWNERs, Horse will not be released to any other OWNER without the written consent of the designated managing agent listed on this Agreement. A Horse and personal property will not be released from STABLE premises for any reason if there is an outstanding balance due on OWNER s account with STABLE. (See paragraphs 14 and 15 of this Agreement). 14. LIEN/SECURITY INTEREST. Prompt and timely payment of OWNER s boarding and STABLE fees is critically important. Should OWNER become delinquent, STABLE is still required to incur ongoing expense in providing daily feed and care to OWNER s horse. For this reason STABLE is protected by various provisions of the Kansas Uniform Commercial Code for the expenses STABLE advances in the daily care and training of the horse. Therefore OWNER agrees that unless otherwise waived in writing, all outstanding balances due for board, veterinary care, farrier work, training, lessons, shows, extra service fees and/or any other fees accrued under this Agreement, shall be paid prior to STABLE s release of the horse. To secure this potential debt, OWNER grants STABLE a lien upon and security interest in the horse, and any foal produced by the horse, if applicable, as well as any tack, equipment, vehicles and/or other personal property of any OWNER of Horse stored on premises to secure payment of all obligations and amounts due under this agreement. STABLE may, at any time until all amounts due hereunder are fully paid, file a photocopy of this contract with the Secretary of State s office in the State in which the horse, foal and other personal property is kept, and when so filed, the copy shall be fully effective as a financing statement as well as UCC-1 security agreement. At any time the OWNER s fees remain delinquent more than sixty (60) days, STABLE may, upon an additional ten calendar days prior written notice to OWNER, foreclose its security interest in the horse and personal property by sale at public auction if the account is not immediately brought current. Ten calendar days prior written notice of such sale by STABLE to OWNER shall be deemed reasonable notice of any foreclosure sale. Time is of the essence in regards to OWNER s obligation to cure any default in order to avoid such sale. 15. STATUTORY LIEN. In addition to paragraph 14 above, Kansas statute, K.S.A , gives STABLE a first and prior lien on any horses and tack or equipment boarded at STABLE, in an amount reasonably necessary to secure the payment of board fees for same. The procedures for foreclosure on this lien differ from, and stand in addition to, those remedies stated in paragraph 14 above. STABLE may, at STABLE s sole discretion, elect which procedure STABLE wishes to follow to collect the debt. 16. PROTECTIVE HEADGEAR OFFERING: OWNER has been made aware of the benefits of wearing protective headgear (riding helmet) by STABLE and understands that the wearing of such headgear while mounting, riding, dismounting and otherwise being around horses, may prevent or reduce the severity of some

7 head injuries, and may even prevent death that may occur as the result of a fall or other occurrence. This is particularly true for minors. Mark an X below in the box before the statement which describes OWNER S choice to wear, or not to wear, protective headgear and/or OWNER s decision relative to minors under the care or guardianship of OWNER. [ ] PROTECTIVE HEADGEAR ACCEPTANCE: OWNER, ON BEHALF OF OWNER AND/OR OWNER S MINOR CHILD OR LEGAL WARD, WILL WEAR PROTECTIVE HEADGEAR. THIS HEADGEAR: WILL BE PURCHASED AND PROVIDED BY OWNER WILL BE PROVIDED BY STABLE [ ] PROTECTIVE HEADGEAR WAIVER: OWNER, ON BEHALF OF OWNER AND/OR OWNER S MINOR CHILD OR LEGAL WARD, WAIVES THE USE OF PROTECTIVE HEADGEAR, ACCEPTING FULL RESPONSIBILITY FOR THE POTENTIAL INJURY WHICH MAY RESULT FROM THIS DECISION. OWNER ACKNOWLEGES THAT OWNER S MINOR CHILDREN MAY BE REQUIRED TO WEAR PROTECTIVE HEADGEAR DURING LESSONS. 17. TERMINATION: a. Without Cause. OWNER and STABLE agree that this agreement may be terminated at any time, by either OWNER or STABLE, without cause, based upon thirty (30) days prior written notice to the other. Notice shall be deemed delivered as of the date it was posted for delivery via U.S. Mail, postage prepaid. Unless otherwise agreed to, all debts accruing under this contract must be paid in full before the horse and personal property will be released to OWNER. b. For Cause. Should OWNER become delinquent in fee payment, or commit a material breach of this Agreement, including but not limited to: fail to timely make all payments due under this agreement, or undertake any action which represents a potential harm or injury to other boarders and their horses and other property, or contribute to or otherwise board an animal in poor health or unsoundness, or with dangerous propensities, habits and/or vices which THIS STABLE is not equipped to handle, or refuse to cooperate with THIS STABLE on reasonable requests relative to the management, health, welfare and safety of animals, people and/or property either on or off-premises, or to obey STABLE rules and regulations, and such actions continue uncured for ten (10) calendar days after OWNER receives written notice thereof, STABLE shall have the right to immediately terminate this agreement. This opportunity to cure is a one-time right only. Subsequent violations of any nature shall result in immediate termination of this agreement and OWNER is expressly prohibited from entering the Premises without prior authorization from STABLE. Any unauthorized entering shall be considered a trespass under applicable Kansas law. Should there be a delinquent balance due on OWNER s account upon Termination for Cause, STABLE reserves all rights under Paragraphs 14 and 15. Should there be no delinquent balance due at time of Termination for Cause and removal demand, but Horse holds over on the Premises for any period of time, OWNER acknowledges that the continued care provided to the horse until time of removal results in daily ongoing expenses to STABLE which remain OWNER s obligation, subject to paragraphs 14 and ACCEPTANCE. This Agreement is not effective until approved and executed by STABLE, which reserves the right to reject any Horse, in its sole discretion, for any reason.

8 19. MERGER, WAIVER, ENTIRE AGREEMENT & SEVERABILITY. This Agreement consists of: this Boarding Agreement, Exhibit A -OWNER Information; Exhibit B - Horse Information and Health Record; Exhibit C Emergency Medical Care Information; Exhibit D Limited Power of Attorney, Exhibits E STABLE Event Liability Release; Exhibit F, OWNER List of Personal Property Stored on Premises; Exhibit G (Fee Schedule) and Exhibit H (Barn Rules) as posted at time of contract and as may be amended from time to time; and subsequent monthly billing statements reflecting fees accrued, each exhibit incorporated by reference herein. This Agreement contains the entire understanding of the parties concerning its subject matter and there are no oral or written promises or representations upon which OWNER is relying except as expressly set forth herein. The Boarding Agreement and STABLE Event Liability Release may be modified only in writing executed by OWNER and STABLE. Headings used herein are for convenience only and are not part of this Agreement. The invalidity or unenforceability of any term or clause of this Agreement shall not affect the validity and enforceability of any other terms or clauses. Any waiver by any party of any violation of, breach of, or default under any provision of this Agreement, by the other party shall not be construed as, or constitute, a continuing waiver of such provision, or waiver of any other violation of, breach of or default under any other provision of this Agreement. 20. APPLICABLE LAW, JURISDICTION, VENUE AND ATTORNEYS FEES. This Agreement shall be construed and governed by the laws of the State of Kansas. Jurisdiction and venue for all disputes connected with this Agreement shall be proper in the county or district in which STABLE is located. OWNER agrees that STABLE, in STABLE s sole discretion, may elect to submit any dispute arising under this Agreement to binding arbitration. STABLE shall be entitled to recover its reasonable attorney s fees and costs incurred in enforcing any provision of this Agreement. 21. ASSIGNMENT. OWNER may not, without the prior written consent of STABLE, assign this Agreement or any of its rights hereunder. 22. MISCELLANEOUS: 3. KANSAS DOMESTIC ANIMAL LIABILITY ACT: OWNER has read and understands the following statutory warning, legislatively enacted at KSA et. seq. (1994) WARNING

9 Under Kansas law, there is no liability for an injury to or the death of a participant in domestic animal activities resulting from the inherent risks of domestic animal activities, pursuant to sections 1 through 4. You are assuming the risk of participating in this domestic animal activity. Inherent risks of domestic animal activities include, but shall not be limited to: (1) The propensity of a domesticated animal to behave in ways, i.e. running, bucking, biting, kicking, shying, stumbling, rearing, falling or stepping on, that may result in an injury, harm or death to persons on or around them; (2) the unpredictability of a domestic animal s reaction to such things as sounds, sudden movement and unfamiliar objects, persons, or other animals; (3) certain hazards such as surface and subsurface conditions; (4) collisions with other domestic animals or objects; and (5) the potential of a participant to act in a negligent manner that may contribute to injury to the participant or others, such as failing to maintain control over the domestic animal or not acting within such participant s ability. 25. LIMITATION OF LIABILITY & INDEMNIFICATION. OWNER UNDERSTANDS THAT EQUINE ACTIVITIES CAN BE DANGEROUS, DESPITE ALL CARE TAKEN BY STABLE. DUE TO THEIR SIZE AND UNPREDICTABLE NATURE, HORSES CAN REACT IN UNEXPECTED WAYS. PERSONAL PROPERTY CAN ALSO BE MISPLACED OR DAMAGED FOR MANY DIFFERENT REASONS. FOR THESE REASONS, OWNER HAS BEEN ENCOURAGED TO TAKE OUT INSURANCE COVERAGE SUFFICIENT TO PROTECT OWNERS INTERESTS. OWNER ASSUMES FULL PERSONAL RESPONSIBILITY FOR ALL INJURIES, INCLUDING DEATH, AND/OR PERSONAL PROPERTY DAMAGE WHICH MAY OCCUR EITHER ON THE PREMISES OR WHILE ENGAGING IN STABLE ACTIVITIES OFF-PREMISES. OFF-PREMISE ACTIVITIES INCLUDE ANY COMPETITIONS IN WHICH STABLE EMPLOYEES ARE COORDINATING OWNER S PARTICIPATION. AS A CONDITION PRECEDENT TO OWNER UTILIZING THESE PREMISES AND PARTICIPATING IN STABLE, PLEASURE OR COMPETITION ACTIVITIES, ON OR OFF-PREMISES, OWNER AGREES ON BEHALF OF OWNER AND/OR OWNER S MINOR CHILDREN AND LEGAL WARDS THAT OWNER WILL NOT BRING A CLAIM OR INITIATE LITIGATION OF ANY KIND AGAINST FIRE STABLES, L.L.C., D/B/A PEEPER RANCH, OR ITS MEMBERS, OFFICERS, TRAINERS, BARN MANAGERS AND/OR OTHER EMPLOYEES OR VOLUNTEERS, OR BRAD AND DAWN FIRE (HEREINAFTER THE RELEASED PARTIES ), FOR ANY REASON, INCLUDING INSTANCES WHICH ALLEGEDLY INVOLVE THE NEGLIGENCE OF ANY OR ALL OF THE RELEASED PARTIES. OWNER FURTHER AGREES THAT ANY OTHER OWNERS (PER EXHIBIT A), OR GUESTS OR FAMILY MEMBERS WHICH OWNER BRINGS ONTO THIS PROPERTY SHALL BE REQUIRED TO SIGN THE STABLE S GENERAL LIABILITY RELEASE, AND OWNER ASSUMES FULL RESPONSIBILITY FOR SECURING THESE SIGNATURES. OWNER FURTHER AGREES TO INDEMNIFY STABLE AND/OR THE RELEASED PARTIES FOR ANY AND ALL COSTS INCURRED BY STABLE AND/OR THE RELEASED PARTIES IN DEFENSE OF ANY CLAIM BROUGHT AGAINST STABLE AND/OR THE RELEASED

10 PARTIES BY THIRD PARTY GUESTS OF OWNER, WHETHER SUCH CLAIM ARISES ON OR OFF PREMISES. SIGNER STATEMENT OF AWARENESS I/WE, THE UNDERSIGNED, HAVE READ AND DO UNDERSTAND THE FOREGOING AGREEMENT, WARNINGS, RELEASE AND ASSUMPTION OF RISK. I/WE HAVE BEEN GIVEN THE OPPORTUNITY TO HAVE THIS DOCUMENT REVIEWED BY LEGAL COUNSEL PRIOR TO SIGNING. I/WE HAVE REVIEWED THE RULES AND REGULATIONS OF THIS STABLE WITH ALL OF OUR MINOR CHILDREN. THIS CONTRACT CONTAINS A BINDING ARBITRATION PROVISION WHICH MAY BE ENFORCED BY THE PARTIES. CONTRACT SIGNATURE PAGE 1. All contracts must be signed by a person 18 years of age or older. OWNER refers to the adult primarily in charge of accepting the terms of this agreement. If a horse is jointly owned by husband and wife, both parties signatures are required. If a horse is owned by non-related individuals, only the signature of the person primarily responsible for decisions related to the horse is required to sign, unless any other OWNERS of the horse wish to ride the horse on the facilities of the STABLE or in off-site STABLE sponsored functions, in which case that/those OWNER(s) must sign this agreement, as well. OWNER Signature STABLE Signature OWNER Signature

11 2. If the Horse will be used by a Minor at any time during the Boarding Agreement, then the signatures of the Minor and BOTH parents of the Minor are required below as evidence of accepting the terms of this Agreement on behalf of the minor. Mother s Name (Print) Mother s Signature Father s Name (Print) Father s Signature 3. Please have all minor children who will be utilizing these premises for equine activities sign below after you have reviewed this contract and applicable barn rules with them. Signature of All Minor Children: Name

12 Name Name Name EXHIBIT A OWNER INFORMATION: Name of Horse: Attach a copy of the most current Registration Certificate of the horse. I. OWNER Information (i.e. Party signing this Boarding Agreement). Please print: Name Address County City State Zip Code Phone Number(s): Social Security and/or Federal Tax # II. ADDITIONAL OWNERS: If HORSE is owned by multiple OWNERS (i.e., a joint ownership, partnership, installment purchase, and/or lease or similar type arrangement), identify specifically the name and address of the person holding the current ownership registration of the Horse.

13 a. Registration Holder: Address County City State Zip Code Work Phone: Home: Cell: b. Other Persons holding Ownership Interest (including Minor Owners of Horse): OWNER, Age (if a minor) & interest: Age: % Interest Address County City State Zip Code Work Phone: Home: Cell: OWNER, Age (if a minor) & interest: Age: % Interest Address County City State Zip Code Work Phone: Home: Cell: PRIMARY OWNER warrants that he/she has been authorized to enter into this contract on behalf of all other Owners of the horse. PRIMARY OWNER Signature: : HORSE INFORMATION & HEALTH RECORD 4. Name of Horse: 5. Turnout. Designate whether your horse, in safety to itself as well as other horses:

14 Should be turned out with other horses in pasture or dry lot Should be segregated in single-horse dry lot turnout. Why:. No turnout. Why:. Other (Explain What and Why:. OWNER acknowledges that horses, although social creatures, will revert to natural behavior such as biting, kicking, rearing, running etc. in behavior inherent to horses, as well as establishing herd hierarchy when turned out together. Should you authorize group turnout for your horse, OWNER shall not hold STABLE liable for any injury to HORSE arising out of group pasture or turn-out or injury or death which occurs from behavior inherent to horses. 3 Horse identification: Age Foaled: Breed Registration Number Sex Mare Gelding Stallion Color: Markings Height: Hands Weight: Estimated Value: $ As per: Purchase Price Insured Value Other: Explain: 4 Name of OWNER/Designated Agent:

15 5 Contact Phone Numbers: Business: Home: Cell: Other emergency contact names & phone numbers: 6 Immunization Record: (Please attach a copy of your current Health Certificate, Coggins and Immunization Records). Complete the following ONLY if your Health Certificate does not specifically identify date of last vaccinations below: of Last Coggins: of Last Rabies: of Last Equine Influenza: of Last West Nile: of Last Tetanus: of Last Sleeping Sickness: 7. Health, Vice and/or Other Issues: Is this Horse prone to Colic, Breathing Disorders or any other medical condition STABLE should be aware of? Yes No Describe and give date and outcome of last incident: Special Instructions to STABLE. Include any known vices of Horse, and identify what special care, if any, is required by Horse (Continue on the back of Exhibit B, if necessary. Known Vices:

16 Special Care: 8. Veterinarian Name & phone number: 9. Farrier Name & phone number: 10. If this Horse is insured, please give full information of insurance carrier, coverages, and emergency care notification contact and phone number: Insurance Company Name: Policy# Coverages: Insurer Contact Name & Phone Number: Do you wish this information to be posted on your horse s stall? If so please provide the notice print-out from your insurer. 11. Feeding Instructions: (If different or in addition to that listed on the Boarding Agreement. OWNER understands that deviations from standard feeding practices may be subject to extra cost): Hay: (Give amount and times per day): Grain: (Give amount and times per day): Supplements: (Identify, amount and times per day of each): ** NOTICE: BOARDERS REQUIRING SUPPLEMENTS FOR HORSES MUST PROVIDE SEPARATE CONTAINERS WITH WRITTEN DETAILED ADMINISTRATION INSTRUCTIONS AND, IF APPLICABLE, APPROPRIATE MEASURING SPOONS. SAID CONTAINERS SHOULD HOLD DAILY DOSES OF SUPPLEMENTS, SEPARATED AND LABELLED FOR AM AND PM FEEDINGS SUFFICIENT FOR ONE WEEK S FEEDING AND

17 REPLENISHED AS NEEDED FOR SUBSEQUENT WEEKS. OWNER WHEN SUPPLEMENT SUPPLY IS RUNNING LOW. STABLE WILL NOTIFY PRIMARY OWNER warrants that he/she has been authorized to enter into this contract on behalf of all other Owners of the horse. PRIMARY OWNER Signature: :