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Biosecurity Horse Health Declaration & Movement Record Form
mmadmin
2024-07-11T00:19:11+10:00
Biosecurity Horse Health Declaration & Movement Record
"
*
" indicates required fields
NAME OF EVENT/ACTIVITY:
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DATE
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DD slash MM slash YYYY
OWNER OR PERSON IN CHARGE OF THE HORSE
Name
*
First
Last
Home Address
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Street Address
Suburb/City
Post Code
Email
*
Phone
*
Vehicle Rego of each vehicle staying on our grounds
PROPERTY OF ORIGIN OF HORSE/S
Full Address (if different from above)
Street Address
Suburb/City
Post Code
PIC Number
*
Venue PIC Number
*
DETAILS OF ALL HORSES BEING BROUGHT ONTO THE GROUNDS
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Number
Registered Name
Sex
Microchip/Brand
Current HVV Yes/No
Add
Remove
Declaration by Owner or person in charge of Horse/s
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I declare that the horse/s named above has/have been in good health, eating normally, and not showing signs of illness during the last 3 days leading up to the attendance to this event today. I give my authorisation for the designated steward to call for veterinary inspection of the horse/s named above and, in my care, should they show signs of illness at any time during the course of the event. I agree to pay any veterinary fees incurred as a result of this.
I AGREE TO ENSURE THAT:
• All horses will be shampooed, rinsed and allowed to dry, and their hooves will be picked clean of all solid material and washed and shampooed.
• All vehicles and equipment accompanying the horses will be in a clean condition at the start of travel to the event.
• The information contained in this Biosecurity Horse Health Declaration is true and correct to the best of my knowledge.
• I agree to abide by all conditions and directions of the Organising Committee.
• I acknowledge that failure to comply with the above may result in refusal of entry to the venue: disqualification or other disciplinary action.
• In the event of horse movement restrictions, each participant will be responsible for the care, maintenance and cost of their horse/s including but not limited to feeding and watering.
• I acknowledge that there is a possibility that horses might become infected with disease agents as a result of any movements and if necessary, horses and premises will be quarantined in accordance with any legislation covering such occurrences including policies and procedures in effect at the time. I agree and acknowledge that the Manager/Event Organising Committee, its State or National Affiliated Bodies and their members are not in any way liable for any cost, expense, loss, damage, action, proceeding or other liability incurred by or made against me as a result of any movement of horses to the event/farm/grounds.
Name
*
First
Last
Date
*
DD dash MM dash YYYY
Signature
*
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