Equine Registration Application
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NAME OF HORSE BREED
_________________/__________/_________/_______________________________/_______________________________
FOALING DATE SEX
COLOR MICRO CHIP #
GELDED
____________________/____________________________________/_________________________/_____________________________
BREED OF SIRE NAME OF SIRE
REG.#
__________________/____________________________________/______________________________/_______________________________
BREED OF DAM NAME OF DAM
REG. #
IF A PEDIGREE FROM EITHER PARENT IS AVAILABLE SEND A COPY OF THE PEDIGREE IN WITH THIS APPLICATION TO HAVE
THE PEDIGREE INFORMATION INCLUDED ON YOUR HORSES A.C.Q.H.A. REGISTRATION CERTIFICATE
PRESENT OWNER SECTION
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PRESENT OWNER OF HORSE
CO OWNER
___________________________________/______________________/________________/________________________________
ADDRESS
CITY
STATE
ZIP
______________________/___________________________/________________________________________________________
HOME PHONE#
CELL PHONE NUMBER E
MAIL ADDRESS
X_________________________________________________________________________________________________________
PRESENT OWNERS SIGNITURE DATE
X_________________________________________________________________________________________________________
CO OWNERS SIGNITURE DATE
BY SIGNING THIS APPLICATION , I DO HEREBY CERTIFY THAT THE INFORMATION ON THIS HORSE IS TRUE AND CORRECT.,
AND I AGREE THAT THIS APPLICATION AND ALL DOCUMENTATION SUBMITTED ALONG WITH THIS APPLICATION BECOME THE PROPERTY OF AcQHA
UPON RECIEPT. I FURTHER AGREE TO ABIDE BY ALL CURRENT AcQHA RULES AND REGULATIONS AND TO DELIVER A COMPLETED AcQHA TRANSFER
APPLICATION WHEN TRANSFERRING THIS HORSE TO A NEW OWNER
