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Domnarski Farm Boarding
Agreement
This agreement is made between the Domnarski Farm, and________________________________________________________(Owner),
owner of the horse described in C. below. Owner warrants that he/she owns the horse and that the horse is negative for
Coggins and is free of disease.
A. Fees: All fees are subject to change given 30 days written notice by the Domnarski
Farm. 1) In consideration of $375 per horse per month ( or $13 per day) paid by owner in advance on the first
day of each month, Stable agrees to board horse beginning ______________________on a month-to-month basis. Fee includes daily
turn outs, stalls cleaned daily, hay and grain twice a day fed by stable as morning and evening feedings. Special needs, medicine,
treatments can be arranged by separate agreement. 2) A late fee of $25.00 will be accrued per horse on the 15th of
each month. 3) If horse damages feeder, hay rack, waterer, etc. owner agrees to pay for a replacement item of similar
quality. Stable agrees to provide labor to replace damaged item. 4) Reasonable additional fees will be charged according
to rates posted in tack room. These fees will be billed to owner. Such bill shall be paid within fifteen (15)days from the
date it is submitted to Owner. 5) Options to basic fees paid in a timely fashion are listed below. Each optional service
requested must be initialed by Owner. These options can be changed at any time the Stable receives written notice from owner.
B. Right of Lien: Stable has the right of lien for the amount due for board and additional agreed upon services
and shall have the right, without process of law, to retain said horse until the indebtedness is satisfactorily paid in full.
C. Description of Horse: Horse’s Barn Name:____________________________________________________________________ Registered Name:______________________________________________________________________ Age:________________Sex:__________________Breed:______________________________________ Color/Markings:_______________________________________________________________________ Height:______________________Registration/Tattoo
No._____________________________________
D. Standard of Care: Stable agrees to provide normal and reasonable care
to maintain the health and well being of said horse as stated in (A.1).
E. Farrier Information: Owner is responsible
for providing a farrier for trimming/shoeing. Owner’s are welcome to contract the services of the Domnarski Farm farrier
Deb Ballou (860)428-3441. If owner is not present, an additional stable charge will be billed. Owner has the right to choose
another farrier but agrees to take full responsibility in scheduling and paying farrier. Preferred Farrier:______________________________________phone
#:_________________________ Do you want us to use another farrier if horse throws shoe,etc.?____________________________________ Additional comments:_______________________________________________________________________
F. Veterinary Information
& Emergency Care: If emergency treatment is needed, Stable will attempt to contact Owner but, in the event Owner is not
reached, Stable has the authority to secure emergency veterinary and or farrier care. Owner is responsible to pay all costs
relating to this care. Stable is authorized as Owner’s agent to arrange billing to Owner. Dr. Sarah Newton of New Braintree,
MA (508)867-0425 & fax (508)867-3321 is Stable’s designated veterinary hospital for routine and emergency veterinary
care. Owner authorizes stable to administer medications and/or treatments.
Domnarski Farm Rules:
1. No smoking on ANY Domnarski Farm property, including inside vehicles on the Domnarski Farm. NO EXCEPTIONS. Violation
of smoking ban by the owner, owner’s farrier or guests will cause for dismissal of horse from the Domnarski Farm and
forfeiture of any fees already paid. 2. Horse Owners, and/or any one else the Horse Owner allows to ride their horse(s),
has a signed “Waiver of Liability and Assumption of Risk” on file with the Domnarski Farm. 3. Horse Owners
and their guests shall conduct themselves in a manner which respects the person and property of others, the safety of all
persons and horses, and exercise good judgment in all activities undertaken at the Domnarski Farm. 4. Newly-arrived horse(s)
shall be on probation for a period of 30 days in order to determine whether or not the horse(s) is/are compatible with the
care arrangements at the Farm. As soon as such a determination has been made, the Horse Owner will be notified. If the horse(s)
is/are to be removed, the Domnarski Farm and Horse Owner will arrange for such action as soon as possible. 5. Supply
a copy of current negative coggins test to Domnarski Farm. 6. Supply evidence of spring shots from the most recent spring. 7. Supply copy of bill of sale, registration paper, jockey club papers or other form of proof of ownership. 8. Maintain
the normal annual immunization program as recommended by your veterinarian, with a record copy to Domnarski Farm. 9.
Maintain a farrier schedule. 10. Pay for the administering of drugs, supplements and medications provided by the Horse
Owner at an agreed upon service charge. 11. You are responsible for providing fly spray and/or masks for your horse during
insect season. 12. For sick care the rate of $20.00 per hour or any portion thereof may apply. 13. Supply a
list of all authorized riders of your horse. All riders must have a completed liability release form on file with Domnarski
Farm prior to riding and must abide by Domnarski Farm rules while on the premises of Domnarski Farm. 14. Any rider under
the age of seven years must have adult supervision while riding and while in the barn area. Riders ages seven through twelve
years of age must have an adult in attendance while riding and while in the barn area. 15. Prior notice should be given
to Domnarski Farm when taking your horse from the premises. 16. Horse owner is responsible for any damage done by his/her
horse, his or her self, his/her companions, or Horse Owner’s authorized user, to Domnarski Farm property. 17. Domnarski
Farm has the right to immediately terminate this agreement with Horse Owner, without refund, for abusing any horse on Domnarski
Farm property, or for repeated improper behavior or violation of Domnarski Farm rules. 18. Domnarski Farm shall be entitled
to a lien against the boarded horse for the value of services rendered, and shall be entitled to enforce said lien according
to the laws of the Commonwealth of Massachusetts, provided; a. Domnarski Farm performs the services herein specified, b. Horse Owner fails to make scheduled payment. 19. Domnarski Farm is not liable for: a. Any accident or injury
to horse, Horse Owner, his/her companions or Horse Owner’s authorized user. b. Damage to or the theft of any tack
or other personal belongings of the above mentioned. 20. Horse owner shall not use tack or personal property of another
without authorization. 21. Horse owner will give a one month’s notice if terminating this agreement. All bills
must be paid before horse leaves Domnarski Farm property, unless otherwise agreed upon. 22. No alcoholic beverages or
drugs allowed on premises. 23. Absolutely no dogs. 24. Do not bring children that require a babysitter without also
bringing the babysitter. Do not allow any children to play in any area where there is horse traffic, or in any paddock or
riding ring. No one of any age is allowed to run in the barn, screech, scream, clap or do anything else that will spook a
horse, without reasonable cause. You are responsible for yourselves, guests and children. Owners of animals are exclusively
allowed in the paddock areas and riding areas. Guests and children should not be present in these areas unless they are working
with an animal. 25. No screaming, yelling, running or disruptive behavior. 26. Communication is encouraged. Feel
free to leave notes on the message board. 27. Sweep up aisle when finished with your horse. 28. If your horse poops
in the riding ring or round pen while working, please remove it. 29. Please put away all your belongings when you are
finished working with your horse. 30. Please check lights and any doors or gates that you may have opened before leaving,
turned off water and drain hose. 31. Please return all tools such as pitchforks, brooms, wheelbarrows, etc. to the place
where they belong when you are done using them. 32. Due to limited storage space, please keep excess equipment/blankets
rarely used at home. 33. For the above reason, please keep all equipment/blankets stored properly on racks provided. 34. Please hose horses outside only. 35. All large trunks must be stored in the loft. One small trunk may be kept in
tack area. 36. The hayloft is to be kept dry at all times. Do not open the access doors to the loft during a time of
precipitation. 37. Please inform management of any farrier/vet/instructor visits as early as possible. 38. Riding
areas are for general use. If you require the ring to yourself (i.e. for a lesson), please post your scheduled time in advance,
to allow the farm and other boarders ample notice. 39. For our own protection, guests who will be riding must sign a
liability release. 40. You are expected to be present for any vet/farrier visits, for general safety. Should you not
be available, you may employ management services at prices listed on inclusion sheet. 41. We are all to respect each
others belongings. Do not help yourself to another’s belongings, supplements or medications without permission. 42.
Do not leave any items which may cause injury to animals in any pasture or turnout area. 43. Do not use chemicals that
are not environmentally safe. Never dump any wash water or empty any container in a pasture area or an area accessible to
horses. 44. Please do not operate the spreader or tractor. If you have an uncontrollable urge to pick out your stall,
please use the wheelbarrow and empty it into the appropriate pile. Please do not leave the wheelbarrow full of manure or blocking
any aisle or entranceways. 45. If someone asks for manure, they are free to take it out of the manure pile. 46.
Do not modify any stall, structure, fencing or any other object, or rearrange any area of the barn without gaining permission
of the barn owner. 47. Do not give any horse treats other than your own, without permission of the owner. 48. Do
not ride any horse, or allow your companions to ride any horse that you do not own. 49. Please do not intentionally ride
on the lawn or in the garden or flower beds. 50. Please do not bring barn cats.
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WAIVER OF LIABILITY
AND ASSUMPTION OF RISK Domnarski Farm,77 Bacon Road, Ware MA 01082, Hamden County, Massachusetts I, the undersigned,
wish to ride horses. I understand that riding horses involves accepting certain risks. Those risks include, but are not limited
to, the risk of injury resulting from falling from a horse, being stepped on or kicked by a horse, from a horse running into
fences, trees, or buildings, and injuries resulting from tripping or falling over obstacles in the riding areas. In addition,
I understand that the injuries sustained from riding horses could be serious or could even result in death. Despite this
and other risks, and fully understanding such risks, I wish to ride horses. I hereby assume all the risks of riding horses.
I also hereby hold harmless the horse owner, if not my own horse, and the owners of Domnarski Farm, and agree to defend them
against any claims or actions resulting from my riding horses, including all expenses and attorney fees. I hereby release
Domnarski Farm, owners, and other horse owners with animals stabled there from any and all liability, and I understand that
this release shall be binding upon my estate and all my representatives. I further acknowledge and understand that any horse
activity, including, but not limited to, feeding, grooming, handling, even being in close proximity to horses, carries
a certain amount of risk. I fully accept this risk for myself and any guests with me. I release Domnarski Farm, its owners,
and/or other horse owners with animals stabled there from any and all liability for any injury or death that may occur from
such horse activities while on the premises and indemnify and hold Domnarski Farm, its owners, and/or other horse owners with
animals stabled there harmless against any such liabilities, such indemnification to include attorney fees. I hereby certify
to Domnarski Farm, its owners, and other horse owners with animals stabled there that I am in good health and do not suffer from any physical limitation that could be aggravated by riding horses. This release applies to the owners of horses on
the premises of Domnarski Farm, to the owners of Domnarski Farm, to owners of any equipment on the premises of Domnarski
Farm, and to any of their heirs, successors, and assignees. I agree to ask the owners of Domnarski Farm for clarification
of any rule or safety procedures, for further instruction as regards anything that I do not understand about the equipment
and the animals, or as regards anything else that may affect the safety of, or riding of, horses on the premises. I also acknowledge
that the owners of Domnarski Farm strongly recommend the use of relevant equine safety gear, such as helmets, but do not specifically
require its use. As such, I accept full responsibility for any and all injuries whether or not I choose to accept this recommendation.
I have fully read this Waiver of Liability and Assumption of Risk carefully and understand that by signing below I am agreeing,
on behalf of myself, my estate, my heirs, representatives and assigns not to sue Domnarski Farm, its owner Lisa A. Domnarski
and/or horse owners with animals stabled there, or to hold him/her/them liable for any injury, including death, from riding
horses. I understand the terms of this waiver of liability and assumption of risk, and I intend to be fully bound by this
agreement. By virtue of my signature, I acknowledge and agree to all terms and conditions set forth on this form and
further acknowledge that I have carefully read this agreement and understand what I am signing. Signature __________________________________________________
Date ___________________________ Date of birth (if < 18 years of age) ________________________________________ Parent(s) or Guardian of Minor Applicant As the parent(s) or Guardian of the applicant, We/I hereby certify that this
applicant (child) is less than 18 years of age. We are/I am aware of the risks incurred in riding horses and the other horse
activities described in the waiver and have discussed them with our/my child. We/I have discussed the rules and safety procedures
with our/my child and are/am satisfied that s/he understands them. We/I understand that by signing below we are/I am agreeing,
along with our/my child, on behalf of ourselves/myself, our/my representatives and assigns, not to sue Domnarski Farm, its
owners, or other horse owners with animals stabled there, or to hold him/her/them liable for any injury, including death,
that results from our/my child riding horses or from any other horse activity. We/I understand the terms of this Waiver of
Liability and Assumption of Risk, and We/I intend to be fully bound by this agreement. Signature(s) __________________________________________________
Date _____________________________ (Please print) Name(s) ________________________________________________________________________________ Street Address _________________________________________ State_____________ Zip ______________ Telephone ___________________________(home)
______________________________ (work) __________________________ (cellular)
WARNING Under Massachusetts
Law, an equine professional is not liable for injury to, or the death of, a participant in equine activities resulting from
the inherent risks of equine activities, pursuant to Chapter 128, Section 2D of the General Laws.
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Emergency Care In the event of an emergency, if the Horse Owner cannot be contacted, the Farm is authorized to contact the following veterinarians
selected by the Horse Owner: First Choice ___________________________________________________________________ Second
Choice _________________________________________________________________ Third Choice __________________________________________________________________ If none of the above listed veterinarians is available, the Farm, acting as an agent of the Horse Owner, is authorized to
contact an alternate veterinarian. Limitations to Emergency Care In the event of an emergency where I cannot be
reached, I, the undersigned Horse Owner would like to impose the following guidelines (limits, if any, to type and cost of
care and emergency procedures): 1) Do everything possible to save the life of the horse, no matter what the cost or time
involved. Yes No Comment:
2) Do everything possible to administer aid to the horse, e.g., broken
leg, but immediate loss of life not eminent. Yes No Comment:
3) Leave the choice to the attending
vet as to whether it is feasible to use drastic care measures or euthanize the horse. Please indicate if you wish a second
opinion. Yes No Comment:
4) Is there a dollar ($) limit that you do not wish to exceed in
emergency care? e.g., the vet states that leg is broken and may be saved, or that the horse has colic and may be saved by
surgery at the farm or hospital, but the initial cost will be $XXXX and continued care cost is unknown. Remember that
even if there are complications during emergency care and costs exceed this amount, you are responsible as the Horse Owner.
Amount $_____________ Comment:
5) If the horse needs to be transported to a veterinary
hospital, who do we contact to move the horse?
6) Is the horse covered by insurance? If so, what is the name
of the company and the telephone contact number for the company?
7) Additional Guidelines and Comments:
G. Routine care required by Stable includes: Tetanus, Strangles & Encephalitis vaccinations once
a year. Intranasal flu and Rhino every 6 months or every 3 months if intra-muscular. Parasite program to include
de-worming every other month or a daily worming program..
H. Exercise STABLE will not provide exercise or
any other care for said horse(s).
I. Risk of Loss: While the horse is boarded at Stable, Stable shall not be liable
for any injury, sickness, death, or theft suffered by the horse or any other cause of action arising from or connecting to
the boarding of the horse. Owner fully understands that Stable does not carry any insurance for any horses not owned by it
for boarding or for any other purposes, for which the horses are covered under any public liability, accidental injury, theft,
or equine mortality insurance; all risks are assumed by Owner. Owner agrees to hold Stable harmless from any loss or injury
to said horse. All costs, no matter how catastrophic, connected with boarding or for any other reason for which the horse
is on the premises of Stable, are to be borne by Owner.
J. Hold Harmless: Owner agrees to hold Stable harmless
from any claim resulting from damage or injury caused by said horse and agrees to pay legal fees incurred by Stable in defense
of a claim resulting from damage by said horse. Termination: Either party may terminate this Agreement given thirty (30)days
notice to the other. In the event of a default, the wronged party has the right to recover reasonable attorneys ’ fees
and court costs resulting from this failure of either party to meet a material term of this Agreement. Owner cannot assign
this Agreement unless Stable agrees in writing. Stable: ___________________________________________________________________ Signature ___________________________________________________________________ Address ___________________________________________________________________ Telephone Number Owner: ___________________________________________________________________ Signature ___________________________________________________________________ Address ___________________________________________________________________ Telephone Number
Owner &Horse Information HORSE ____________________________ Owner:_______________________________________________Home
phone:___________________________ Address:______________________________________________Business phone _________________________ ______________________________________________Cell phone _____________________________ E-Mail:______________________________________________Fax
phone _____________________________ Description of you: Have
you ever been involved in a lawsuit, or made insurance claims for liability or personal injury? ____________ If yes, please
explain: _________________________________________ ______________________________________________________________________________
Have you ever been arrested and if so list date(s) and reason for arrest(s) ___________________ ______________________________________________________________________________
We do not owe you an explanation of any sort as to why you were accepted or rejected.
Emergency Information: For horse, contact ___________________________________phone #_______________________ For rider, contact ____________________________________phone
#______________________ Physician __________________________________________phone #_______________________ Hospital
Preference:__________________________________________ Does your horse have medical insurance? _________If so, company
_______________________________ policy #________________________phone #__________________(Please provide us with a copy.)
Please indicate the type of behavior that we can expect from your horse, or general items that we should be aware
of:
o Kicks o Bucks o Rears o Bites o Fence fighter o Paces o Paws o Chews wood o Cribs (windsucks) o Frequently
fights for king of the heap o Socially inept o Jumps fences o Runs through fences o Prone to colic o Hoof problems o Cannot be caught o Loves toys o Pregnant o Mare provokes males o Lame o Blind or nearly blind o Deaf or nearly deaf
o Navicular/Arthritis o Weaves
We are here because we love horses and want to provide good care to yours. We try
to balance the needs of each horse within the parameters of our farm, budget, and the needs of other horses. Please help us
determine your horse’s needs so we can maximize his comfort at Domnarski Farm.
Additional comments:________________________________________________________________ ____________________________________________________________________________________________________________________________________________________________________________ Feeding Information: Full board includes quality grass hay and grain. We can determine their diet from their condition
and will adjust accordingly. Do you have any preferences? a.m.: ____flakes of grass hay ____flakes of alfalfa _____pounds
of oats (scoop =’s 3 1/2 lbs.)______vitamins p.m.:____ flakes of grass hay ____flakes of alfalfa _____pounds of
oats
Additional feeds or medications: a.m.:__________________________________________________________________________________
p.m.:__________________________________________________________________________________
Additional comments:_____________________________________________________________________________
Turn out Information: One turn-out is defined as each time a horse is removed from stall and left out in
paddock, loafing shed, arena or pasture and then returned to stall OR a 12 hour period. For outside winter turnouts we require
you to provide a waterproof blanket/sheet if horse is blanketed in stall. Turn-outs areas and time to be determined by us.
Boarded horses are turned out individually unless Stable and Owner have determined otherwise. Since stable can lower stall
cleaning costs on horses placed out overnight, these horses may receive more turn-out time under general boarding agreement. Please note your preferences in order of choice. Number only those you prefer.(1,2,3,4,5) Winter preferences:(weather
permitting)____loafing shed (includes all night)____outdoor (full time)____outdoor (limit time,1 hour)____indoor (1 hour) Summer choices:____day &night pasture ___day only pasture ____day only paddock ___night only pasture____night only paddock
___loafing shed (includes all night)____outdoor (limit time,1 hour)____indoor (1 hour) Has your horse been out on pasture
before?________Is your horse at risk on pasture (founder/colic)?_____ Has horse ever been out all night?_________Is your
horse trained to electric fence?________ Been turned out with geldings?______Mares?________Is your horse aggressive to
other horses?______ Have other horses injured your horse?________Is your horse injury prone when turned out?______ Description of regular use of your horse: How often do you work your horse? _________________________________________________ What time do you normally work the horse during the week? _____________________________ weekends _____________________________ holidays _____________________________ How often will your horse be taken off the property and returned for showing,
hunting, lessons, trail rides, etc.
Additional comments:________________________________________________________________________
Stable Information: We keep a daily log in the tack room which is available for you to review at any time.
It lists which horses were turned out that day, where, and who did it. Who fed grain or hay that day. Which farriers or vets
were/are scheduled to visit. Injuries that may have occurred or medications horses received. A melamine board hanging
in the office list which horses have been turned out that week and on what days. It also includes the last time each horse
was vaccinated, wormed, or had farrier work. We also keep permanent records of each horse while they are boarded with
us. This includes history of vaccinations, wormings, and farrier work. It also includes owner information and medical records
on horse. Please ask, if you would like to review your horses permanent records. Barn Rules and Current Fee Charts are
hanging in office as well as in viewing room. We will be happy to answer questions during business hours,(8:00 a.m. to 8:00
p.m.) Thank you for taking the time to fill this information sheet out. It helps us know your horse better.
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