55
Cardigan StreetAngle Park SA 5010
P.O. Box 2352
Regency Park S.A. 5942
Tel (08) 8243 7100
Fax (08) 8268 2870
55
Cardigan Street
Angle Park SA 5010
P.O. Box 2352
Regency Park S.A. 5942
Tel (08) 8243 7100
Fax (08) 8268 2870
NOTIFICATION
OF
RETIRED
GREYHOUND
R106
Proper
care
(welfare)
of
greyhounds
in
the
event
that
they
either:
(a)
do
not
commence
racing,
or
alternatively
(b)
they
have
finished
their
racing
career.
DETAILS
OF
RETIRED
GREYHOUND
|
Greyhound |
Ear
Brand |
Micro
Chip |
Age |
Status
of
Retirement |
Owners |
|
|
|
|
|
|
|
1.
Retired
as
Pet
(Name
and
Address
where
greyhound
will
be
housed)
2.
is
used
for
breeding
(Name
and
Address
where
greyhound
will
be
housed)
3.
has
been
accepted
into
4.
humanely
euthanised
(Declaration
MUST
be
signed
by
Veterinary
Surgeon
or
Agent)
5.
other
(Statutory
Declaration
of
explanation)
DETAILS
of
PET
or
BREEDING
GREYHOUNDS
Name:……………………………………….
GRSA
Licence
Number:…………………………….
Full
Address
:………………………………………………………………………………………………..
Phone
No.:………………………………………….
Mobile
No.:………………………………………….
Signature
of
new
Owner/Breeder:…………………………………………………………………………...
*I
am
the
Owner
of
the
above-mentioned
greyhound,
*I
am
authorized
by
the
owner
to
present
the
greyhound
for
euthanasia.
(*
Cross
out
which
does
not
apply)
In
consideration
of
the
said
Veterinary
Surgeon
providing
the
requisite
treatment,
and
arranging
disposal
of
the
body,
I
agree
to
pay
him/her
the
prescribed
fee.
I
further
agree
to
indemnify
him,
his
servants
or
agents,
from
any
loss
of
liability
which
they
may
incur
as
a
result
of
any
inaccuracy
whether
intended
or
otherwise
in
this
declaration.
Signature
of
Owner
or
Authorised
Agent:
…………………………………….…………………………..
Name:
………………………………………………………………….
Date:……………………………
NOTICE
TO
VETERINARY
SURGEONS
GREYHOUND
CERTIFICATE
or
NAMING
FORM
MUST
BE
PRODUCED
Veterinary
Surgeon
or
Agents
Signature:
………………………………………………………………….
THIS FORM MUST BE LODGED BY THE AUTHORISED PERSON ALONG WITH GREYHOUND CERTIFICATE
