Equine Vaccine Clinic Sign Up Form Name on Account with Bishop Vet*If you are a new client, you must also fill out the New Client FormHorses to be Treated (Name, Age, Breed, Color)Clinic You Are Signing Up ForHIGHWAY 6 (Chalfant/Hammill/Benton)Bishop Saddle ClubBig Pine Saddle ClubStarlite*DO NOT USE THIS FORM FOR CLINICS NOT LISTED ABOVE. If you your horse is at Millpond or Hidden Creek you must sign up with them directly.Physical Address of Horse(s) LocationSpecial Instructions (Which Gate, Location of Halters, Etc)Will you be present? If you will not be present, you must prepay or leave a credit card on file with the office. Payment of cash or check can be given day of clinic, credit card payments must be done prior.YesNoFriend/family will be there for meWhich Services do You Request?All Recommended vaccines (Fall- Flu rhino, Spring- 5way/West Nile and Strangles)ONLY 5WAY/WNVONLY FLU-RHINOONLY STRANGLESDewormerFloat*Float and Sheath clean*Rabies vaccine*Not all clinics allow for floats to be done on the same day. A separate float clinic may be schedule if increased needCAPTCHAPhoneThis field is for validation purposes and should be left unchanged.