By submitting this form, I declare that I wish to have the above named veterinary clinic considered to be a HSI designated clinic for the pre-stallion inspection veterinary examination.
I agree to abide by the terms and conditions outlined in this form and I have read and understand the prescribed HSI stallion veterinary process.
I declaring I have no current or potential conflict of interests as a HSI designated clinic.
I confirm that the above-named clinic has all the facilities and the capacity to carry out the stallion examinations described in the form and Appendixes.
I, the undersigned, certify that I have full power and authority to execute and file this application and the foregoing particulars are true and accurate in every respect.
In the event of any particulars becoming inaccurate updated revised particulars will be furnished immediately in writing to Horse Sport Ireland ("HSI"):