APPLICATION FOR THOROUGHBRED FOAL …

KHRC Form 70-1 (6/15). Kentucky THOROUGHBRED Breeders' Incentive Fund APPLICATION for Mare Registration Please print clearly and submit completed form by August 15th by mail, fax, or email to: KENTUCKY HORSE RACING COMMISSION. 4063 Iron Works Pkwy, Bldg. B | Lexington, KY 40511. Ph: 859-246-2847 |Fax: 859-246-2887 | Email: | breeder INFORMATION: (The intended breeder of record as it will be reported to The Jockey Club). Breeder_____. Street _____ City _____ State _____ Zip_____. Phone_____ Fax _____ E-Mail _____. BOARDING FARM INFORMATION: (Mare must maintain residence in Kentucky to qualify). Farm_____ Farm Owner/Manager_____. Street _____ City _____ State ____ Zip_____. (No PO Box). Phone_____ Fax _____ E-Mail _____. COVERING SIRE NAME OF MARE MARE'S SIRE OF MARE. YEAR OF. BIRTH. Page _____ of _____. COVERING SIRE NAME OF MARE MARE'S SIRE OF MARE. YEAR OF. BIRTH. AFFIDAVIT BY breeder OR breeder 'S AUTHORIZED AGENT. I hereby certify that the information contained in this APPLICATION is accurate and complete, and I.

COVERING SIRE NAME OF MARE MARE’S YEAR OF BIRTH SIRE OF MARE AFFIDAVIT BY BREEDER OR BREEDER’S AUTHORIZED AGENT. I hereby certify that the information contained in this application is accurate and complete, and I

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