New Customer Registration Form & Contract
Customer Details:
Full Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Barn Address if Different from Mailing address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
E-mail
example@example.com
Equine Information
My Horses Tag Number/ Name is
.
Horses approximate age
.
Equine is halter broke:
Yes
No
Equine is
Mare
Gelding
Stallion
Horse
Donkey
Tell us what you know about the equine:
I understand Fonzy's Farm is a short term quarantine and rehab and animals are not meant to be at the facility longer than 90 days. I also understand prices can change at any time with reasonable notice.
Yes
No
I agree to have my animal's healing journey shared on Fonzy's Farm Social Media.
Yes
No
I agree to pay all invoices, veterinary and farrier bills in full before the equine will be released to my care. I also acknowledge a $10 per day late fee for invoices not paid in full within 48 hours of the invoice being sent. If I fail to pay for these services and become more than 28 days over due, I agree the equine becomes the property of Fonzy's Farm equine to do as they please.
Yes
No
I agree that any medications, wound care supplies, supplements, farrier care, vet visits, etc will be paid for by the horse owner.
Yes
No
Death or Injury to Horse- Stable, its Boarders, trainers, agents or employees will not be held responsible for injury or death of Horse in the unless there is negligence on their part. I agree to not hold Fonzy's Farm responsible for the death of the animal in this contract and understand that animals coming from Kill Pens and Auction houses can be in bad health (injuries, pnemonia, strangles, etc)and death can occur from these illnesses.
Yes
No
I agree in an emergency, where a veterinarian has determined humane euthanasia is the best option for the equine and I am unable to be reached, Fonzy's Farm can make the decision to humanely euthanize the equine.
Yes
No
The services I am requesting for my equine are: (ivermectin included once in 30 day qt cost, as well as fresh alfalfa/coastal hay and grain (12/5 or senior)
30 days quarantine (normal body score)- $550 (18.33/day)
30 days quarantine (body score of 3 or below/wound care needs)-$650 (21.66/day)
30 days quarantine (mini/donkey/foal-yearling)- $450 ($15/day)
30 days quarantine Mini/Donkey (starvation or wound care)-$500
Additional dewormer- $25
Bowie Transportation-$100
Kemp Last Chance Transportation- $250
Cleburne Auction Transport-$150
Vet transport- $100
1 hour full body equine massage -$75
30 min massage to injured area- $50
Halter and Lead Rope- $30
Farrier- $45-$65
Training- $50/Hour
How did you hear about us?
*
Please Select
Facebook
Internet
Friend or Family
Other
Please Specify
*
Suggestions if any for further improvement:
This form was completed to the best of my ability and I agree to everything completed on this form.
Submit
Should be Empty: