Activity Name: Arrival date: Departure date:

Owner or person in charge of horse/s:

Mobile: Email:

Property address:

Town/City:
P/Code:

P.I.C Property Identification Code legally required by the Queensland Department of Primary industries PLEASE LIST BELOW, ALL HORSES YOU HAVE WITH YOU TODAY.
P.I.C
Number
Hendra Vac Date of last
Vaccination
Microchip
Number
Breed
of Horse
Description of Horse
Example:- Chestnut, white flash
Registered Name
of Horse
Stable Name
of Horse Yes! No!






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 shown signs of illness during the last 3 days leading up to the
above mentioned reason for entering the grounds. I give my authorisation for the RASQ biosecurity officer to call for a veterinary inspection of the horse/s named above and in my care should they be showing
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:
1. If required before movement, all horses will be shampooed, rinsed and allowed to dry, and their hooves will be picked clean of all solid materials and washed with shampoo or antiseptic spray.
2. All vehicles and equipment accompanying the horse/s should be in a clean condition at the start of travel to the Toowoomba Showgrounds.
3. The information contained in this Horse Health Declaration is true and correct to the best of my knowledge.
4. I agree to abide by all conditions, rules and regulations and directions of the RASQ, Equestrian Queensland, Biosecurity Queensland Event organisers.
5. I acknowledge that failure to comply with the above may result in refusal of entry to the venue, disqualification or other disciplinary action as decided by the above mention regulatory bodies/judiciary or disputes committee.
6. In the event of horse/s movement restrictions, each participant will be responsible for the care, maintenance and costs of their horse/s including feeding and washing

Signature Print full name Date

HORSE HEALTH DECLARATION
for
Clive Berghofer Events Centre
TOOWOOMBA SHOWGROUNDS
CAMPING & STABLING
Are you Stabling horse/s overnight? (Please tick): Yes!

No!

Are you Camping overnight? Yes!

No!


Please, tick the nights you have booked stables and Camping and complete the Indemnity waiver below if leaving stabled livestock unattended.
Booked Nights
Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Sun Mon
Stabling

Camping


INDEMNITY WAIVER
In consideration of livestock being stabled/yarded at the Toowoomba Showgrounds whilst unsupervised.
I, of
Agree not to make any claim against the Royal Agricultural Society of Queensland for any loss or injury sustained at the Toowoomba Showgrounds
Acknowledge that no insurance is provided on my behalf and I am responsible for arranging my own public liability and all other insurance.
Will ensure that all stables/yards are fully secured and regularly cleaned of waste products, food and manure.
Acknowledge that the Royal Agricultural Society of Queensland staff or volunteers are not responsible for my livestock or equipment.


Signature Print full name Date

Other Information or Comments