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There are errors with your form submission. Please review and submit again
Email address *
Full Name (First, Middle, Last) *
Home Address *
City, State, Zip Code *
Home Phone *
Cell Phone
Horse Name & Registered Name *
Breed *
Registration Number *
Year Foaled *
Sex *
Height (in hands)
Insurance Company (if applicable) *
Veterinarian's Name and Phone Number *
Is this Horse Halter Broke and able to Stand Tied for Clipping, Saddling and Grooming, etc? *
Please answer diligently
To what Extent has this Horse been Worked in a Round Pen? *
Please answer diligently
To what extent has this Horse been Worked in an Arena? *
Please answer diligently
How much Cumulative Riding does this Horse have? *
Please answer diligently
What Problems are you Currently Having with this Horse? *
Please answer diligently
What are your Future Plans/Goals for this Horse? (i.e., pleasure, show, trail ride, jump) *
Please answer diligently
Has this Horse been Shown or Competed? *
If yes, please list what kind of shows and any major awards the horse has earned.
Do you have a Specific Student you would like to Request to Work With? *
Please note we cannot guarantee.
How did you Hear about the Adrian College Equestrian Program? *
Please answer diligently
DOCUMENTS & VACCINE REQUIREMENTS PRIOR TO ARRIVAL TO FACILITY *
Negative Coggins (Dated in the last year)
Copy of Registration Paper, if applicable
FLU AVERT I.N. (10-30 days before arrival)
Rhinopheumonitis (10-30 days before arrival)
Strangles (Booster within last year)
Tetanus (within last year)
Deworming (60 days prior to arrival)
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