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 #:

Horses attending event
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, space, 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: space Date: space

(Complete a separate form for different owners.)

For event officials' use only:

Date and time of arrival: space Event official initials: space

Date and time of departure: space Event official initials: space

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