SINGAPORE TURF CLUB – VETERINARY DEPARTMENT

FORM A - MEDICATION AND VACCINATION DECLARATION

Horse Name: ______

Representing Country: ______

Country of Embarkation: ______

Passport Number: ______

Issuing Authority: ______

Scheduled Departure Date to Singapore: ______

The trainer of this horse must complete this Medication & Vaccination Declaration Form A and email it at least 7 days prior to the horse departing for Singapore. Copies of the vaccination certificate from the passport must be attached to this form. He must also update this form and email it again on the day of departure if additional medications were given after the first report. Please email to:

Dr Koos van den Berg

Head: Veterinary Department

Singapore Turf Club

1 Turf Club Avenue

Singapore Racecourse

Singapore 738078

Tel: (65) 6879 1330

Fax: (65) 6879 1349

Email:

This form must include all anabolic substances, corticosteroids and other long-acting substances administered within 6 months of departure date and all other medications administered to the horse within 14 days of departure date. Due to unpredictable clearance times, Singapore Turf Club does not guarantee that these medications will not be detected in samples collected in Singapore.

Important Note: There is a 7-day withdrawal time for sedatives and tranquilizers. Please make sure that you take this into account at the time of loading for transport.

I ______(name of Trainer) hereby declare

that the above described horse was administered with:

Anabolic substances, corticosteroids and other long-acting substances administered within 6 months of departure
Date Administered / Medication
Trade Name / Drug Name
All other medications administered within 14 days of departure
Date Administered / Medication
Trade Name / Drug Name
All Equine Influenza and Japanese B Encephalitis vaccinations administered
Date Administered / Vaccination
Trade Name / Strains in vaccine
All other vaccinations administered within 30 days of departure
Date Administered / Vaccination
Trade Name / Drug Name

I have also read and understand the following:

Horses will be required to provide blood and urine samples for analysis for prohibited substances on arrival at International Isolation Stables at the racecourse.

Any horses reported positive to long-acting substances will not be permitted to race unless a clear analysis can be obtained at least 7 days prior to raceday. Horses with evidence of anabolic steroid administration will NOT be allowed to race.

The Singapore Turf Club will not bear the travelling expenses of any horse which is not permitted to race because of prohibited substances and such expenses will be charged to the owner of that horse.”

Name: ______

Address: ______

______

______

Tel: ______

Fax: ______

Email: ______

Signature: ______Date: ______

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For Singapore Turf Club Use Only

Date of Receipt: ______

Approved / Not approved for travel

Signed by: Head: Vet Dept / Vet Surgeon: ______Date: ______

Comments:

FORM A Page 1 of 4