National Farm and Facility Level Biosecurity User Guide for the Equine Sector
Annex 7: Sample horse event participant declaration
Event information
Event name:
Event location:
Event date(s):
Information for contact person
Name of person in charge of horse(s) at the event:
Address:
Email address:
Home phone #:
Cell phone #:
Truck licence plate #:
Trailer licence plate #:
Horse's name | Breed | Identification (colour, markings, brand, electronic identification) | Sex | Age | Resting horse temperature (<38.5°C) |
---|---|---|---|---|---|
Address of property (premises identification) from which the horse was moved to the event: | |
---|---|
Address of property (premises identification) to which the horse will move after the event (If different from above): |
Alternate contact information (For other individuals affiliated with horses):
Name:
Cell phone #:
Name:
Cell phone #:
Horse health declaration:
I, , declare that the horse(s) named above has/have:
- been in good health;
- been eating normally;
- body temperature(s) below 38.5°C (101.3°F);
- and not shown signs of infectious disease for the three (3) days preceding arrival at this event including transport.
Signature: Date:
(Complete a separate form for different owners.)
For event officials' use only:
Date and time of arrival: Event official initials:
Date and time of departure: Event official initials:
- Date modified: