Skip to content
Toggle Navigation
Annual Show
Events
Venue Hire
Camping
Markets
Committee
Membership
Biosecurity Horse Health Declaration & Movement Record Form
mmadmin
2025-01-13T18:10:54+10:00
Biosecurity Horse Health Declaration & Movement Record
"
*
" indicates required fields
NAME OF EVENT/ACTIVITY:
*
DATE
*
DD slash MM slash YYYY
OWNER OR PERSON IN CHARGE OF THE HORSE
Name
*
First
Last
Home Address
*
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
*
Number
Registered Name
Sex
Microchip/Brand
Current HVV Yes/No
Add
Remove
Declaration by Owner or person in charge of Horse/s
*
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.
Waiver, Release, and Acknowledgment
*
I acknowledge that I have read and fully understand the contents of this Waiver, Release, and Acknowledgment Form. I understand that by signing it, I am relinquishing certain legal rights, including the right to sue. I sign this document freely and voluntarily, without any inducements, and intend for my signature to serve as a complete and unconditional release of all liability to the fullest extent allowed by law.
A. Definitions:
For the purposes of this Waiver, Release, and Acknowledgment Form, “the Society” refers to:
(a) All affiliated entities;
(b) Servants, agents, and employees of the Society and/or its affiliated entities;
(c) Members and volunteers of the Society and/or its affiliated entities.
By participating in the Event, I acknowledge and agree to the following:
1. Assumption of Risk and Release of Liability
I acknowledge that my participation in the Event is voluntary and at my own risk. I accept all inherent risks associated with my participation and release the Caboolture & District P.A. & I. Assn Ltd. and any associated individuals or bodies from any claims, demands, or legal proceedings arising from my participation. This release applies to any injury, loss, or damage to myself or my property, whether arising from negligence, breach of duty, or otherwise, and binds my heirs, successors, and legal representatives.
2. Indemnification
I absolve the Society and all associated parties from liability for any injury or damage to myself or my property during my participation, regardless of the cause. I accept full responsibility for any harm or damage that may result from my participation.
3. Acknowledgment of Risk
I understand that participation in the Event carries a significant risk of injury, including but not limited to serious injury or death, and I fully accept these risks.
4. Physical Fitness and Medical Condition
I warrant that I am physically fit to participate in the Event and have not been advised otherwise by a qualified medical professional. I also agree to disclose any pre-existing medical conditions or other factors that could affect my ability to participate or increase the risk of injury to myself or others.
5. Accuracy of Information
I affirm that all personal information I have provided is accurate and complete to the best of my knowledge.
6. Compliance with Instructions
I agree to follow all instructions, rules, and regulations set by the Society and any associated parties during the Event. I understand that failure to comply may result in my removal from the Event, and I indemnify the Society against any claims arising from my failure to follow the instructions.
7. Indemnification for Third-Party Claims
I indemnify the Society and all associated parties against any claims made by other individuals for injury or damage resulting from my participation in the Event, whether due to negligence or otherwise.
Name
*
First
Last
Date
*
DD dash MM dash YYYY
Signature
*
Page load link
Go to Top