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150-Day Layoff Report - Mountaineer
Trainers must complete this form for any horse that has not raced for 150 days or more. The form will be submitted to Dr. Lori Bohenko, Lori.L.Bohenko@wv.gov, prior to entry. The form must be completed and submitted a minimum of 30 days* before entry, and is valid for 60 days from the date of submission. This does not apply to first-time starters. *This requirement may be waived by Dr. Bohenko.
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Horse Name/Tattoo or Microchip #: *
Horse's Age *
Date of Last Race: *
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Track of Last Race: *
Planned Date of Entry: *
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Planned Track of Entry *
Owner:
Owner Phone/Email:
Trainer: *
Traîner Phone/Email: *
Primary Veterinarian: *
Primary Veterinarian Phone/Email: *
Specify Reason For Layoff *
How long has this horse been in your care? *
(if less than 30 days) Previous Trainer:
Previous Trainer Phone/Email:
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