Full-Blooded Chincoteague Pony Registration Application

1
Please review the Registry Rules and Regulations prior to submitting application. Complete the application with as much information as you have available. If additional information is needed for registration the registrar will contact you. Leaving blank or writing unknown/NA is acceptable. The required fields are marked with a *. If you don’t know the parentage of your pony please contact ICPAR on the "Pony Tracing & ID Program" page prior to submitting the registration form with photos and any documentation proving your pony is a Chincoteague Pony.
2
You will be asked for 5 photos of your pony later in this form, please make sure you have good lighting, 3 photos will be used on your pony's certificate. Please provide clear photos of the pony standing square. Photos of the following views of the pony are required: right side, left side, front, back, and full face showing all markings.
3
Owner Name* This field is required.
First Name
Last Name
4
Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
United States
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curacao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
5
Farm Information
Prefix Name (If you have one registered with ICPAR)
Farm Name
Farm Website
6
Phone Number* This field is required.
7
Email* This field is required.
example@example.com
8
Registered Name Choices* This field is required. Please include three name options for you pony *ICPAR has the right to disallow names that are unsuitable or similar to a previously registered names at its discretion.
Registered Name Choice #1
Registered Name Choice #2
Registered Name Choice #3
9
Pony Date of Birth* This field is required.
Date
Year
Month
Day
10
Pony Information
City & State/Province Foaled
Color
Sex
Date if Gelded/Spayed
Height (Approximate mature height if under 5 years of age)
Eye Color
11
Eye Color/Markings
Right eye (if different than stated eye color)
Left eye (If different than stated eye color)
Markings
Identifying Marks (Brands, whorls, Scars, etc)
12
Important submission information below, please read before you continue
13
If color Tested Please Upload ReportPlease make sure your file is completely uploaded before continuing. If it is not, you will have to re-fill out the form when you try to submit.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
14
Right Side* This field is required.*Please note that the registrar will chose the photos that will be used on the certificate and that all submitted photos MUST be either owned by the applicant or used by permission of the original photographer. ICPAR takes no responsibility for photos that are submitted without the original photographers permission, if a photo is suspected to be used without permission ICPAR will request proof of photographic ownership or permission in the form of written consent by the original photographer. (Please make sure your file is completely uploaded before continuing. If it is not, you will have to re-fill out the form when you try to submit.)
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Right Side
Cancelof
15
Left Side * This field is required.Please make sure your file is completely uploaded before continuing. If it is not, you will have to re-fill out the form when you try to submit.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
16
Front* This field is required.Please make sure your file is completely uploaded before continuing. If it is not, you will have to re-fill out the form when you try to submit.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
17
Back* This field is required.Please make sure your file is completely uploaded before continuing. If it is not, you will have to re-fill out the form when you try to submit.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
18
Full Face* This field is required.Please make sure your file is completely uploaded before continuing. If it is not, you will have to re-fill out the form when you try to submit.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
19
Other PhotoPlease make sure your file is completely uploaded before continuing. If it is not, you will have to re-fill out the form when you try to submit.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
20
Breeder Information
Owner of sire at time of stallion service
Owner of dam at time of Stallion Service
21
If you are the breeder or purchased your pony from a breeder, please include a breeder’s certificate. If the pony was bred by the CVFC, please enclose a bill of sale. Additional options are recent coggins test (within the past 2 years), transfer of ownership papers, bill of sale or health certificate to verify ownership of the pony.* This field is required.Please make sure your file is completely uploaded before continuing. If it is not, you will have to re-fill out the form when you try to submit.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Bill of sale/Breeder's certificate/Auction Receipt or Coggins/Health Certificate
Cancelof
22
#1 Extra Upload area for if neededPlease make sure your file is completely uploaded before continuing. If it is not, you will have to re-fill out the form when you try to submit.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Bill of Sale/Breeder's Certificate/Auction Receipt or Coggins/Health Certificate
Cancelof
23
#2 Extra Upload area if neededPlease make sure your file is completely uploaded before continuing. If it is not, you will have to re-fill out the form when you try to submit.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Bill of Sale/Breeder's Certificate/Auction Receipt or Coggins/Health Certificate
Cancelof
24
Auction InformationIf the pony was purchased from the CVFC please provide the auction number and a copy of the auction receipt if available.
CVFC Auction Number
Auction Price
Microchip number & Company (If applicable)
25
Other RegistrationsIf registered with another registry please provide registry name, number, and a copy of the papers
Registry 1#
Registry Number
Registry #2
Registry Number
26
Registration Papers #1Please make sure your file is completely uploaded before continuing. If it is not, you will have to re-fill out the form when you try to submit.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
27
Registration Papers #2Please make sure your file is completely uploaded before continuing. If it is not, you will have to re-fill out the form when you try to submit.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
28
Sire's Pedigree
Sire
Sire's Sire
Sire's Dam
29
Dam's Pedigree
Dam
Dam's Sire
Dam's Dam
30
If DNA Parent Verified Please Upload ReportPlease make sure your file is completely uploaded before continuing. If it is not, you will have to re-fill out the form when you try to submit.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
31
*Please note that by submitting information to or registering with the International Chincoteague Pony Association & Registry your pony's information will show up on the "Chincoteague Pony Pedigree Database." * This field is required.by submitting this form I understand that my pony's pedigree and other information regarding my pony that is being submitted may be published on the Chincoteague Pony Pedigree Database
I have read and agree to the above statement
32
Owner information, Farm name, and Farm website will not be listed on the Chincoteague Pony Pedigree Database, unless it has been previously recorded. If you would like any of this information listed please check the boxes below.* This field is required.
Owner Name
Farm Name
Farm Name & Website
None
33
Additional Comments
34
If you are planning on registering more than one pony within the next two weeks please indicate below label like the following (1 of 2) or (I will be registering 3 ponies) If you are only registering one pony please put (1) in the box below * This field is required.
35
Submission Agreement *The International Chincoteague Pony Association & Registry LLC (ICPAR) exists to preserve, protect, and promote the Chincoteague pony. e International Chincoteague Pony Association & Registry LLC recommends and expects that all persons will conduct themselves in an honest, forthright, ethical, and sportsmanlike manner in their relationships with each other at any time they are involved in Chincoteague pony-related matters. By submitting this application and accepting the benefits of transacting business with the ICPAR, I hereby subject myself to all the provisions of the By-Laws, Rules and Regulations, Code of Conduct & Grievancy Policy, and the Privacy Policy of the International Chincoteague Pony Association & Registry LLC, as they now exist or may, from time to time, be amended. Knowledge of which I currently have or will immediately acquire from the Registry by emailing chincoteagueponyassociation@gmail.com or online at chincoteagueponyassociation.com. All information is correct to the best of my knowledge and belief as certified by my submission of this form and signature below. Any fraudulent statements herein automatically cancel registration.* This field is required.
ClearPlease sign here
36
When you have submitted this form you will be automatically directed to the payment linkClick on "Full-Blooded Registration" and then type in your first pony name choice
37
Then click "Add to Cart" and finish paying by going through the checkout.
38
Thank you so much for registering with us!If you have any questions or comments on how we can improve our services, please write them here.
Huge
Large
Normal
Small
Ok
Ok
39
When this form is submitted you will receive an email saying that we have received your submission* This field is required.
Should be Empty: