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About
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Stallions
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Service Agreement

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- Step 1 of 3

Surname: *

First Name *

Residential Address *

Address Line 1

City

State / Province / Region

Postal Code

Is Your Postal Address Different to Your Residential Address? *

Yes
No

Postal Address *

Address Line 1

City

State / Province / Region

Postal Code

Email *

Home

Work

Mobile

Service Particulars

Mare *

If you would like to add multiple mares, please fill in the form again.

Freeze Brand

Stallion Requested *

Service Fee *

Bred Last Season? *

Yes
No

In Foal? *

Yes
No

Slipped *

Yes
No

Empty *

Yes
No

Last Service Date

Location of Mare

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Insemination Site - Vet/Stud

Phone *

Email *

I Agree to the Terms & Conditions *

Yes

Please Click Here for the Terms & Conditions which apply to this agreement. In signing this agreement I certify that I am the person responsible for all payments of all accounts including the Service Fee. Please note any discounts given will be revoked if payment terms are not met. Semen transport charges will be invoiced separately and are payable on 7 days.

Print Name *

(Person or authorised agent responsible for Service Fee/charges)

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166 Beutel Rd, Patrick Estate QLD 4311
chantal@somersetfarms.com.au
0413 336 872

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