Applica�on Form for Horse/Pony REGISTRATION (Passport)

(Updated November 2020)

The Coloured Horse and Pony Society (UK)

CHAPS (UK) Registra�on is available to ALL Coloured Horses and Ponies

If you require confirma�on of receipt, please enclose an SAE.Please allow 15 workings days turnaround.

For full informa�on on the legisla�ve requirements for passports, please refer to www.chapsuk.com A direct link to DEFRA may also be found on this site

This Registra�on provides you with the required Passport for EC Conformity & is a LIFETIME Registra�on

NAME: 1st Choice:

Sex:

Date Ownership Commenced:

Breeder’s Name & Address (if known):

Address of Owner:

Post Code:

E-mail:

Telephone:

CHAPS Membership No:Name of Owner:

Mobile:

REGISTRATION FEES: FOR LIFE (4 as appropriate)

Other Society(ies) Horse Reg’d with:

Country of Birth: Type (eg Hunter, Tradi�onal, Miniature, American):

Es�mated Adult Height: cms/ (hh) Date of Birth: / /20

2nd Choice:If using a Prefix, please ensure that it is registered with CPR and CHAPS (UK). In the case of an unregistered prefix being used, it will be struck off and the name only registered. For more informa�on regarding prefixes please refer to www.centralprefixregister.com; or apply to CHAPS Admin for a prefix registra�on form.

(Please state Filly, Colt, Mare, etc.)

BREEDING: Where known

(Mr, Mrs, Miss, Ms, etc)

Registra�on may only be made by an adult, 18 years or over.

o Registra�on of MEMBERS’ Horses or Ponies = £36.00 inc VAT o Registra�on of NON-MEMBERS’ Horses or Ponies = £46.00 inc VAT

**In line with the “one-horse-one-passport” policy, if a DEFRA approved passport is already held this must be forwarded for overstamping; SEE SEPARATE FORM.

From �me to �me your name & address may be passed to other organisa�ons,

shows, etc. If you DO NOT wish us to do so, please �ck (4) this box.

Please read all instruc�ons carefully – PLEASE USE BLOCK CAPITALS THROUGHOUT

CHAPS QUALIFIER CARD(S) - Applicable ONLY for CHAPS UK MEMBERSThe following Card(s) will only be issued to horses/ponies which are owned and exhibited by CHAPS (UK) current Showing Member(s).Please provide (�ck (4) as appropriate) for the following Horse/Pony: o CHAPS Qual’n Card IN-HAND (free of charge)

Qualifier cards will not be issued without a CURRENT membership number being quoted above. o CHAPS Qual’n Card RIDDEN (free of charge)

(Please enclose a copy of valid Height Cer�ficate for all Non-Na�ve exhibits 158cms or under and Nat/Cob/Trad type exhibits 148cms or under when applying for a CHAPS Ridden Qualifica�on Card.)

Before submi�ng this form, please check the following:o You are aged over 18 years; and are correctly enclosing the MEMBER or NON-MEMBER Registra�on Applica�on fee - as applicable; (If you are submi�ng as a Member your current Membership Number MUST be completed above; or Mem Applica�on made at same �me)

o If you wish to become a Member you can submit a Membership Applica�on at same �me;o If using a Prefix, it is in line with CPR criteria;o Veterinary Iden�fica�on Report overleaf is completed;o The correct fee is enclosed by cheque/postal order payable to CHAPS UK, or BACS/PayPal paid; and �cked accordingly below.

RETURN TO: CHAPS (UK), Grange Co�age, North Scarle Road, Wigsley, No�nghamshire NG23 7EU. Tel: 01522 703784.

VAT Reg No 752 7667 00

Where breeding is known, please provide posi�ve proof of any breeding/pedigree for the above-named horse/pony. This must be in the form of a society issued covering cer�ficate complete with a copy of the sire’s pedigree if not CHAPS registered, and a copy of the mare’s registra�on and pedigree. In the case of animals issued with a pedigree registra�on cer�ficate (i.e. APHA(US)), then a copy should be forwarded to ensure pedigree inser�on into the passport. DNA verifica�on required for all yearlings and over.It is recommended that all foals should firstly be registered with the society which has issued the covering cer�ficate (where one exists) so that the licence and pedigree can be confirmed and correctly inserted into the passport.For DNA verifica�on (refer to www.chapsuk.com for informa�on on animals requiring DNA, this includes all those bred by A.I.) please apply to CHAPS (UK) Administra�on for a kit, giving your details, foal’s name, D.O.B., sire and dam and a cheque for £30.00. The kit will be sent out to you in order that the vet can take the sample at the same �me as microchipping. Both kit and applica�on form should then be returned to CHAPS Administra�on.

PLEASE NOTE: A DISCOUNT is available if you Register mul�ple horses/ponies - 3 or 4 Registra�ons, 5% discount; 5 or more Registra�ons, 10% discount. Discount only applies when all Registra�ons applied for at the same �me.

I/We* (* delete as applicable) agree to abide by the Rules of this Society Signature: Date:

OR

PAYMENT INFORMATION Please TICK as appropriate:

Registra�on Fee (if owned by a CHAPS Member) £36.00 inc VAT (Above fee applicable if you are a current Member, or are submi�ng a Mem. App. at same �me)

OR Registra�on Fee (if owned by a Non Member) £46.00 inc VAT

**ALL PASSPORT WILL BE RETURNED BY SIGNED FOR POST**

TOTAL ENCLOSED £

CHAPS2021REGISTRATIONAPP-Nov20

Registra�ons may also be paid using PayPal Buy Now bu�on on the homepage at www.chapsuk.com

(please reference payment to Registra�on details)

E &S R PO OH N YD E S

R O

U C

O IEL TO YC

Est 1983

Payment method: please tick (4)

BACS BACS - Lloyds; Acct No 02107284; Sort Code: 30-92-97

Cheque Postal Order Cheques/Postal Orders payable to: CHAPS UK

Date Rec’d:

UELN issued/date:

CHAPS Reg No issued:

Chq Banked:

OFFICE USE ONLY

ALL PASSPORTS WILL BE RETURNED BY SIGNED FOR POST.

COLOUR (ROBE) SEX (SEXE)

Filly Colt Gelding

DATE of BIRTH (ANNEE)

/ /

/ /

ESTIMATED ADULT HEIGHT SIRE COLOUR (PERE ROBE) DAM COLOUR (MERE ROBE)

Description taken by:(Signalement relevé par):

HEAD (TETE)

NECK(ENCOLURE)

L.F. (A.G.)

R.F. (A.D.)

L.H. (P.G.)

R.H. (P.D.)

BODY(CORPS)

ACQUIRED MARKS(MARQUES ACQUISES)

LEG

S (P

AT

TES)

DATE of EXAMINATION Was the foal on the mare

at the time of examination?

YES NO

VETERINARY CERTIFICATE of AGE and MARKINGS – INSTRUCTIONS1. Position of microchip must be clearly marked on this diagram, denoted by an M . This form MUST then be signed by the veterinary surgeon who inserted or checked

the microchip. Barcode must be attached in space provided below.2. Written description and diagram should be typed or written in BLOCK CAPITALS in BLACK ink and must be completed by the Veterinary Surgeon ONLY and signed

accordingly. 3. Written description and diagram should agree. All white markings should be hatched in red. Whorls must be shown thus ‘X’ and described below in detail.

LEFT SIDE (COTE GAUCHE)

RIGHT SIDE (COTE DROIT)

MUZZLE (NEZ)

LEFT(GAUCHE)

LEFT(GAUCHE)

RIGHT(DROIT)

HEAD and NECK VENTRAL VIEW(TETE et ENCOLURE VUE VENTRALE)

FORE REAR VIEW(ANTERIEURS VUE

POSTERIEURE)

HIND REAR VIEW(POSTERIEURS VUE

POSTERIEURE)

RIGHT(DROIT)

PLACE MICROCHIP BARCODE HERE

Signature & Stamp of Veterinary Surgeon

If the animal being registered is solid with less than 3 whorls this must be done using the “Solid Registration” form ONLY.

I am a Veterinary Surgeon and member of the RCVS and have read the above microchip with an ISO 11785 scanner having:(Delete part (a) or (b) as applicable)

(a) Implanted the microchip (b) Found existing microchip

Where a microchip was implanted, I also declare that the animal was scanned prior to insertion and no existing chip was found.