Application for Service

Application for Service

2025-26 Season | Stallion Service Request
IMPORTANT:

Submission of this application form does not constitute acceptance of the Mare for breeding. Backwater Performance Horses reserves the absolute right, at its sole discretion, to decline any application and/or refuse service to any mare without providing a reason,. Acceptance will only occur once the Mare has been assessed, all required health and registration documents have been received, and written confirmation has been issued by Backwater Performance Horses.
Select your preferred Stallion:
MARE OWNER'S DETAILS
Name:

First NameLast Name
Company Name (if applicable):
ABN
ACN
Email Address:
example@example.com
Address:

Street Address

Street Address Line 2

CityState

Postcode
Mobile Phone Number:
Please enter a valid phone number.Format: (000) 000-0000.
Please indicate the Owner's registration/s:
Owner/Company ASHS Member No:
Owner/Company AQHA Member No:

VETERINARIAN'S DETAILS
Mare's Treating Veterinarian's Name:
Vet's Address:

Street Address

Street Address Line 2

CityState

Postcode
Vet's Email Address:
example@example.com
Vet's Business Phone No:
Please enter a valid phone number.Format: (00) 0000-0000.
Vet's Fax No:
Please enter a valid phone number.Format: (00) 0000-0000.
Vet's After Hours Phone No (Mobile Preferred):
Please enter a valid phone number.Format: (0000) 000-000.

MARE OWNER'S DETAILS