Waiver Of Liability/ Consent Form - West Wind Veterinary Hospital


Waiver of Liability/ Consent Form
I, _________________________________________ (Horse Owner or Authorized Agent Name) authorize West
Wind Veterinary Hospital (WWVH) and Equistar Vet Services (EVS) to work on my horse:
__________________________________ (registered horse Name). The procedures to be performed include the
Please initial all that apply:
AI Fresh:
Name of Stallion: _____________________________________
AI Frozen:
Name of Stallion:______________________________________
Collect Stallion
Freeze Semen
Embryo Transfer
Open Caslick
Other: _____________________________________________________________________________
1. I hereby agree to leave my mare / stallion to be bred and / or cared for by West Wind Veterinary Hospital
2. All fees are due and payable at time of departure including fees for veterinary services, board, farrier, shipping
costs and any transportation costs. Some additional fees may have to be added after the horse has gone home; such
as, shipping, Canada Customs duty, taxes etc.
3. All stallion contracts are to completed and paid for by the mare owner prior to the mare being bred. A copy of
the completed stallion contract, stallion owner contact information, receipt of payment and a copy of the mare’s
registration papers are necessary before breeding.
4. All horses must be dewormed within 30 days of arrival and vaccinated against WEE/EEE/Tetanus/West
Nile (4 way) and Flu/Rhino (2 way) 2 weeks prior to arrival. Any horse not recently dewormed or vaccinated
will be treated on arrival and billed to the owners account.
5. All animals to be left in the care of WWVH must be in good general health and shall be free of infectious,
contagious or transmittable diseases. Horses will be examined on arrival and unhealthy animals will not be able to
6. The horse owner acknowledges that the activities taking place at WWVH (such as: breeding, collecting, foaling
and inseminating) are by their inherent nature dangerous activities and that participation by the horse owner,
his/her personnel, and horse(s) exposes them to risk of sickness, injury or death. Horse owner expressly
acknowledges that participation involves a broad range of inherent risk, including but not limited to:


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