Royal Agricultural Society of New South Wales ABN 69 793 644 351 trading as AUSTRALASIAN ANIMAL REGISTRY Locked Bag 4317, Sydney Olympic Park NSW 2127. Phone: (02) 9704 1450 Fax: (02) 9704 1006 Email: [email protected] Web: www.aar.org.au www.aar.org.nz APPLICATION FOR REGISTRATION By signing this application both the Implanter and the Owner accept the AAR terms and conditions which have been issued to this clinic. ATTACH MICROCHIP NUMBER BARCODE STICKER BELOW IMPLANTER NUMBER OR NAME & BUSINESS ADDRESS AAR Date Of Implant (dd/mm/yyyy) / / 2 Implanters Signature 0 Tag Number Identification Number of Any Other Permanent Identification Device Implanted in the Animal First Name of Owner Mr Mrs Miss MS Surname of Owner Unit Building Number Street Town State Post Code Municipal District (Council) Where Animal is Kept Postal Address (If different from residential address above) Address Where Animal is Kept (If different from residential address above) Day Phone After Hours Phone Mobile Email Address Name of Alternate Contact Alternate Phone Alternate Mobile Animal's Name Species Breed Date of Birth (dd/mm/yyyy) Male Neutered Female Spayed / Colour Please Indicate if Your Animal Has Been Declared As: Dangerous Menacing / A Restricted Breed I DO NOT give permission for my contact details to be made available to any authorised person for the purpose of recovery of my animal. I declare the details above are true & correct - Owner/Agent Signature Telephone Support Password Date (dd/mm/yyyy) / PLEASE PRINT IN BLOCK LETTERS / 2 0 53554 Please find following a microchip registration form for the Australasian Animal Registry Would you kindly complete, sign and return to our office with cheque, money order or credit card details for the amount of $AUD 9.00 per animal at your earliest convenience. If you have any further queries, please do not hesitate to contact our office. IMPORTANT PLEASE PRINT, COMPLETE AND SEND YOUR PAYMENT AND COMPLETED REGISTRATION FORM(S) TO: LOCKED BAG 4317 SYDNEY OLYMPIC PARK NSW 2127 AUSTRALIA WE REQUIRE THE ORIGINAL SIGNED COPY OF THIS FORM(S) TO BE SENT. FAXED COPIES WILL NOT BE ACCEPTED PLEASE MAKE SURE YOUR PAYMENT IS SECURELY ATTACHED TO YOUR REGISTRATION FORM. Please find enclosed my cheque/money order in the amount of $________ OR Please debit my credit card for the amount of $________ VISA MASTERCARD CARD NUMBER: _______________________________ EXPIRY DATE: ____/____ CARDHOLDERS NAME: _________________________ CARDHOLDERS SIGNATURE: ____________________ Please Note: Credit Cards will be debited in favour of “RAS of NSW cashiers” and be debited before action taken Royal Agricultural Society of New South Wales ABN 69 793 644 351 (“RAS”) trading as AUSTRALASIAN ANIMAL REGISTRY (“AAR”) TERMS AND CONDITIONS OF DATA ACCEPTANCE The AAR maintains an Australasian wide database of animals implanted with an identification microchip. The Registry is maintained and operated by the Royal Agricultural Society of NSW and provides a 24 hour, 7 days a week information service. For more information visit our web site: www.aar.org.au or www.aar.org.nz Listed below are the terms and conditions of acceptance of information for registration on the AAR data base. 1. 2. 3. 4. 5. 6. 7. 8. 9. The RAS accepts no responsibility for the accuracy of any information provided by the Implanting Veterinary Body (IVB’) to the RAS for the registration on the AAR data base. Delivery of information is to be made to the offices of the AAR as nominated by the RAS from time to time. The RAS shall have the right to query any information provided by an IVB or an owner and the IVB or owner shall make available to the RAS all confirmatory information as is required by the RAS by way of assurance as to the correctness of any information. The IVB warrants that information provided to the AAR is sent in a timely manner and is accurate in detail. Except where expressly agreed in writing, these general conditions for acceptance of information shall override any terms and conditions requested by any IVB. The RAS reserves the right to not accept any data, whether incomplete or otherwise, if its operations are hindered or suspended as a result of fire, accident, strike, lockouts or any other cause or causes beyond its control and no action shall be brought against the RAS arising out of such hindrance or suspension. The IVB or the owner (where applicable) indemnifies the RAS against loss or damage to the RAS and any claims by any person against the RAS in respect to any loss or death of any animal arising out of or as a consequence of information supplied by the IVB or by the owner (where applicable) to the AAR. The IVB or the owner (where applicable) releases the RAS from any claim arising out of any loss or death to any animal arising out of or as a consequence of information supplied by the IVB or the owner (where applicable) to the AAR. Delivery of information for registration to the AAR constitutes acceptance of the terms and conditions set out herein. No alterations to these terms and conditions shall be binding on the RAS unless accepted by the RAS in writing and any terms and conditions contained herein are in addition to any other rights the RAS may have at law.