Trainer Placement Form – Goulburn Greyhound Racing Club

Dogs Kennel name *

By placing a dog on our program I agree that the dog is of sound and even temperament (ie. not aggressive or extremely timid) and is sociable in the presence of other dogs or people. *

Yes
No - please contact me for options with this dog

I am aware of the new non muzzle law applicable to Greyhounds on the NSW pet register and am I comfortable placing this dog in public with no muzzle whilst on a lead. *

Yes
No- please contact me with information on how to get the dog ready to muzzle free in public

I understand this dog may not be automatically accepted if not pet ready and might be requested to undertake a GAP assesment *

yes
No

My current club membership status is *

Nowra Greyhound Racing Club - $100 donation to the clubs welfare fund
Goulburn Racing Club - No Fee
Bulli - GOBOTA - $100 donation to the clubs welfare fund
Canberra Racing Club - $100 donation to welfare fund
I am not a club member - $300 donation to the clubs welfare fund

For your donation, we will pay your desexing, teeth cleaning, C7 booster and deal with the council to transfer the dog onto the CAR register and update Ozchase. Lifetime council registration, as well as a change of owner for NSW, will be completed as well.

I am the *

Owner
Owner-Trainer
Agent / 3rd party

Name *

First

Last

Oz Chase ID *

Owners name if different

Please ensure you have permission to list the dog for adoption. If not please contact GWIC to arrange the transfer

Current address of dog *

Mobile number *

Email ( this is where we will send an invoice) *

Dogs race name *

Microchip number *

Earbrand *

Sex *

Male
Female

Colour *

DOB *

Weight *

Preferred vet for procedures *

Currently desexed? *

No
Yes

I agree to cover any additional expenses not covered directly with the vet on the day of the procedures such as teeth removal if needed. *

Yes

Has the dog been raced? *

Yes
No

Reason for retirement. Please include any known injuries including fractures. *

Has the dog been to a GAP assessment day? *

No
Yes

The dog is pet ready and has or will be exposed to the following before it leaves for its new home *

Time alone away from other dogs
Inside the house
A walk on the street ( even just around your block) to learn to not pull

Please check all the boxes the dog has had exposure to. *

How would you describe this greyhounds overall personality? Please tick all that apply *

Type of home you recommend for this dog

Exercise level *

Energizer battery - daily walks needed
Pretty chilled. Wont mind if it doesnt get out every day but 3-4 times a week would be ideal
Lazy sod - good luck getting it off the lounge for a walk 🙂

Tell us about your dog and the type of personality it has. This is where we get the information to list your dog. Lack of information will result in delays in getting the dog listed *

The information we are after here are what pet people want to know. Loves a snuggle, loves to watch TV, Loves to chill int he sun, lounge chair friendly etc.

Note section. Anything we need to know? ie you have spoken to Glenn or Natalie and we asked you to include a note? *

I agree to supply a clean tidy collar, correctly fitted muzzle and a coat if leaving in winter. Please select an option.

I will supply the above at the time the dog leaves.- Please do not send the dog with dirty broken collars or coats. or we will bill you for new gear.
Please supply the above for me and add $65 to my invoice.

You agree to continue to look for other options to re-home your dog as there is no guarantee of a home or time frame and the dog will remain with you until an option becomes available.. *

Yes

DECLARATION, UNDERTAKINGS & AUTHORISATION

By submitting the above form I declare that the particulars contained in this form are true and correct and agree to the declaration below

I declare that the particulars contained in this form are true and correct and that I understand it is a serious offence under the Greyhound Racing
Rules and the Greyhound Racing Act 2009 to make a false declaration and / or provide false or misleading information at any time to GRNSW. I
will advise GRNSW if there is any change in the particulars in this form. Failure to disclose full and accurate information to GRNSW when
requested by GRNSW as part of its welfare, regulatory and supervisory activities may result in penalties and further action being taken by
GRNSW or other relevant regulatory and law enforcement agencies.
PRIVACY POLICY
By signing this document you consent to us (Greyhound Racing New South Wales ABN 61 018 166 136, our related bodies corporate, affiliates
and agents) collecting, using, holding and disclosing personal information about you. You can find out more about how we deal with your privacy
by viewing our privacy policy at www.grnsw.com.au/policies/grnsw/privacy-policy. We may seek and obtain further personal information
(including sensitive information) about you during the course of our dealings with you. The terms of this consent apply to the collection, use and
disclosure of that information. If you do not provide us with this consent or provide us with your personal information we may not be able to
provide services to you.