All horses must have a satisfactory Certificate of Veterinary Inspection (CVI) completed within 14 days of the event AND proof of a current (within 6 months) rhinopneumonitis vaccination to compete at the 2022 Montana 4-H State Horse Show. Other vaccinations recommended are Eastern/ Western Equine Encephalomyelitis, Tetanus, Influenza, Rabies, and West Nile. ONE CVI PER HORSE.

Montana State 4-H Horse Show

The Cottonwood Equine Center 11 CC Lane Joliet, MT 59041 September 9-11, 2022

Each horse must be inspected at home/locally. There will NOT be a veterinarian on the grounds to perform on-site inspections.

Please present this Certificate of Veterinary Inspection at event check-in before unloading.

Show committee reserves the right to refuse entry to suspect animals at check-in or require removal of suspect animals during the event.


Owner’s Information: __________________________________________________________________________________

Address: _______________________________________________________________________________

City                                                                                                       State                                                    Zip                                         

Horse’s Name (Registered and/or Common)                                                                                                                             

Age of Horse                   Sex of Horse                    Breed of Horse                                              Color                                   

Vaccination History (note date administered, lot # if available, and who administered):

________ Rhinopneumonites: _______________________________                              ________ Rabies: _______________________________ 

________ West Nile: _______________________________                                                ________ Tetanus: _______________________________ 

________ Influenza: _______________________________                                                 

________ Eastern/Western Equine Encephalomyelitis ______________________________________________________

Veterinary Inspection

Temperature: ____________________   Pulse: ____________________   Respiration Rate: _______________

Lymph nodes normal?   Yes       No             Nasal Discharge?     Yes     No

Additional Findings: ______________________________________________________________________________________________________________________________________



I, __________________________________________________________________, DVM, have examined the horse named above for signs of disease on (day/time)



I find this horse to be free for visible signs of infectious disease.


Veterinarian's Signature