Owner Surrender Form

For Broodmares Seeking A Career Change!
Before continuing, please confirm whether the horse you're placing is, has been, or was intended to be a broodmare.

YesNo
Please return to the the previous page and select the appropriate form:

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Your Name*

First NameLast Name
Your Relationship to the Horse
ie: owner, farm manager, authorized agent
Mobile Number*
Format: (000) 000-0000.
Email*
example@example.com
Mare's Registered Name*
Mare's Year of Birth*
Current Owner*
Can enter "same" if the owner is the same as above
Location of the Horse*
ie: Farm Name, city, state
Reason for seeking placement:
Breeding history, including when last bred.*
Any known prior surgeries or injuries?*

YesNo
Please describe
Any current injuries or conditions?*

YesNo
Please describe
List vices or behavioral issues*
Anything else you'd like to share about the mare?
Does the horse have a current coggins (required for placement)?*

YesNoNo, but I will get one
Veterinarian or Clinic with records and/or medical history on the horse*
Veterinarian's Phone*
Please enter a valid phone number.Format: (000) 000-0000.
If you have any pictures of the horse, please upload them here:

Cancelof
By signing below, you consent to have any veterinary records released to After the Races. You also certify that all information submitted is correct and accurate to the best of your knowledge.
Should be Empty:

For Broodmares Seeking A Career Change!