SPPHAV - PERFORMANCE CARDS

*Title

*First name

*Last name

*Email

Phone

*ADDRESS

*SUBERB

*POST CODE

Photographic consent

I confirm I have read and accept the terms of the Privacy Policy

Photographic consent and release statement. Leave un-checked if you do not wish to consent.

Postal Address

If different from your main address

*Registration Prices ($AUD)

Gelding $20.00 (AUD)

Mare $35.00 (AUD)

Stallion $50.00 (AUD)

Colt <5yrs $20.00 (AUD)

Select the sex of Standardbred to be registered

Dam	Please include brand if known. ie. S3124587 or Please write NRS after a horse’s name if it is already registered in the Non-Racing Stud Book – that is the horse is a purebred but not freeze branded.

Breeders Name

Hero Welfare Statement

YES

NO

With your consent your horses details and your name and address will be sent to Harness Racing Victoria’s Hero Program
for entry into their Horse Welfare data base. Select 'No' to opt out of this request.

Has your Standardbred raced

YES

NO

Is this horse still racing

YES

NO

Race History

Number of wins total prize money major race wins.

Other Registrations

Please indicate if this horse is registered with any other horse associations. Please include name of association and the horses registration number .

*Owner DNA obligation acknowledgement:

This statement and your acknowledement are required to register your horse qith SPPHAV.

Sire Breed

If other breed is from the Sire.

Dam Breed

If other breed is from the Dam.

% Standardbred bloodlines

Must be at least 25% Standardbred

SPPHAVINC

Donation