Online Entry Form Test

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Owner Information


Please enter as much information as you can so we can always contact you about your horse(s). Any additional information about your horse(s) is greatly appreciated.



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Owner Name or Authorized Agent:
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Email:
Please enter a valid email address
Please enter a valid email address
Member Number:
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Address 1 or P.O. Box
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Address 2 or P.O. Box
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City:
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Country:
  • - select a country -
  • United States
  • Australia
  • Canada
  • Denmark
  • England
  • Finland
  • France
  • Ireland
  • Italy
  • New Zealand
  • Norway
  • Russia
  • Sweden
  • Other
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State/Prov:
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Zip / Postal Code:
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Work Phone:
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Home Phone:
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Fax:
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Cell Phone:
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Other:
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Other:
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Horse Information


Please enter as much information as you can to help us enter your horse.



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Horse Name:
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Sex:
  • - select -
  • Colt
  • Filly
  • Ridgling
  • Gelding
  • Mare
  • Horse
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Type:
  • - select -
  • Weanling
  • Yearling
  • Broodmare
  • Broodmare Prospect
  • Racehorse
  • Stallion Share
  • Stallion
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Registration Number:
Only 6 characters allowed
Only 6 characters allowed
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Gait:
  • - select a option -
  • Pacer
  • Trotter
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Enter Stallion Share Information
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Stallion Share #:
Only 4 characters allowed
Only 4 characters allowed
How Many Breedings Per Season:
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Broodmare Status
  • - select a option -
  • In Foal
  • Barren
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Enter In-Foal Details
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In Foal To:
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Date Last Bred:
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Previous Foaling Season:
  • - select a option -
  • Live Foal
  • Died
  • Was a Maiden
  • Was Barren
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Sire of Foal:
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Sex:
  • - select a option -
  • Colt
  • Filly
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More Weanling Info
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Color:
  • - choose color -
  • B
  • Br
  • Blk
  • Ch
  • Gr
  • Ro
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Date of Birth:
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Choose racehorse status
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  • - select a option -
  • Racing at time of consignment and to sale
  • Will be racing at sale time
  • In training
  • Turned Out
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Sire:
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Dam:
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Which Staking Company do you use?
  • - select a option -
  • Bluegrass Staking Service, Inc.
  • Chapman's Staking Service, Inc.
  • Joanne's Staking Service, Inc.
  • SelfStake.com
  • Other/NA
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Farm / Stable Location:
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Address:
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City:
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State / Prov.
  • - select state / prov. -
  • Alabama
  • Alaska
  • Arizona
  • Arkansas
  • California
  • Colorado
  • Connecticut
  • Delaware
  • District of Columbia
  • Florida
  • Georgia
  • Hawaii
  • Idaho
  • Illinois
  • Indiana
  • Iowa
  • Kansas
  • Kentucky
  • Louisiana
  • Maine
  • Montana
  • Nebraska
  • Nevada
  • New Hampshire
  • New Jersey
  • New Mexico
  • New York
  • North Carolina
  • North Dakota
  • Ohio
  • Oklahoma
  • Oregon
  • Maryland
  • Massachusetts
  • Michigan
  • Minnesota
  • Mississippi
  • Missouri
  • Pennsylvania
  • Rhode Island
  • South Carolina
  • South Dakota
  • Tennessee
  • Texas
  • Utah
  • Vermont
  • Virginia
  • Washington
  • West Virginia
  • Wisconsin
  • Wyoming
  • ------------------------------------
  • Alberta
  • British Columbia
  • Manitoba
  • New Brunswick
  • Newfoundland and Labrador
  • Northwest Territories
  • Nova Scotia
  • Nunavut
  • Ontario
  • Prince Edward Island
  • Saskatchewan
  • Yukon
  • Other
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Trainer / Farm Contact:
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Work Phone:
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Cell Phone:
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Owner's Statement, Stakes Engagements or something personal about your horse.
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Registered Owner:
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Email Address:
Please enter your email address.
Please enter your email address.
Member Number:
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City:
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State/Prov.
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Country:
  • - select a country -
  • United States
  • Australia
  • Canada
  • Denmark
  • England
  • Finland
  • France
  • Ireland
  • Italy
  • New Zealand
  • Norway
  • Russia
  • Sweden
  • Other
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Zip / Postal Code:
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Home Phone:
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Work Phone:
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Cell Phone:
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Fax:
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Registered Owner:
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Email Address:
Please enter your email address.
Please enter your email address.
Member Number:
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City:
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State/Prov.
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Country:
  • - select a country -
  • United States
  • Australia
  • Canada
  • Denmark
  • England
  • Finland
  • France
  • Ireland
  • Italy
  • New Zealand
  • Norway
  • Russia
  • Sweden
  • Other
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Zip / Postal Code:
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Home Phone:
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Work Phone:
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Cell Phone:
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Fax:
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Registered Owner:
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Email Address:
Please enter your email address.
Please enter your email address.
Member Number:
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City:
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State/Prov.
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Country:
  • - select a country -
  • United States
  • Australia
  • Canada
  • Denmark
  • England
  • Finland
  • France
  • Ireland
  • Italy
  • New Zealand
  • Norway
  • Russia
  • Sweden
  • Other
Field is required!
Field is required!
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Field is required!
Zip / Postal Code:
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Home Phone:
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Work Phone:
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Cell Phone:
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Fax:
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Registered Owner:
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Email Address:
Please enter your email address.
Please enter your email address.
Member Number:
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City:
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State/Prov.
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Country:
  • - select a country -
  • United States
  • Australia
  • Canada
  • Denmark
  • England
  • Finland
  • France
  • Ireland
  • Italy
  • New Zealand
  • Norway
  • Russia
  • Sweden
  • Other
Field is required!
Field is required!
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Zip / Postal Code:
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Home Phone:
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Work Phone:
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Cell Phone:
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Fax:
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