Fillable 2020.02.14 RIAMS Hiring Out Horses Application Form Hiring out of horses licence application form - Eastbourne Borough Council

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2020.02.14 RIAMS Hiring Out Horses Application Form Hiring out of horses licence application form - Eastbourne Borough Council

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  • 35 check-boxes
  • 165 other fields

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Page 1 of 7
The Animal Welfare (Licensing of Activities Involving Animals) Regulations 2018
Application for a licence to carry out the activity of hiring out horses
1
Reference number
1.1
System reference number
1.2
Your reference
Please complete all the questions in the form.
If you have nothing to record, please state ‘not applicable’ or ‘none’
2
Agent
2.1
Are you an agent acting on behalf of the
applicant?
Yes No If ‘no’, go to 3
2b
Further information about the agent
2.2
Name
2.3
Address
2.4
Email
2.5
Main telephone number
2.6
Other telephone number
3
Applicant details
3.1
Name
3.2
Address
3.3
Email
3.4
Main telephone number
3.5
Other telephone number
3.6
Applying as a business or organisation,
including a sole trader?
Yes No
3.7
Applying as an individual?
Yes No
4
Applicant business
4.1
Is your company registered with
companies house?
Yes No If ‘no’, go to 4.3
4.2
Registration number
4.3 Is your business registered outside the
UK?
4.4 VAT number
4.5 Legal status of the business
4.6 Your position in the business
4.7 The country where your head office is
located.
Page 2 of 7
4
Applicant business
4b
Business address – this should be your official address, i.e. the address required of you by law to
receive all communication
4.8
Building name or number
4.9
Street
4.10
District
4.11
City or town
4.12
County or administrative area
4.13
Postcode
4.14
Country
Please complete all the questions in the form.
If you have nothing to record, please state ‘not applicable’ or ‘none’
5
Type of application
5.1
New Renewal If new, go to 5b
5.2 Existing licence number
5b
Further information about the applicant
5.3
Date of birth
6
Establishment to be licensed
6.1 Name of premises/trading name
6.2
6.3 Telephone number
6.4 Email address
6.5
Is the establishment open throughout the year?
Yes/No
6.6 When is it normally open?
6.7
Do you have planning permission for this
business use?
Yes/No
7
Accommodation and facilities
Please describe the accommodation available for horses:
7.1 Stalls (please give the number)
7.2 Boxes (please give the number)
7.3 Covered yard (please give dimensions)
7.4 Open yard (please give dimensions)
Please describe the land available for:
7.5 Grazing
7.6 Instructing or demonstrating
7.7 Exercise
Please describe the accommodation available for:
7.8 Forage and bedding
7.9 Equipment and saddlery
Please describe the arrangements in place for:
7.10 Water supply and watering horses
7.11 Disposal of animal waste
7.12
Protection of horses in event of a fire,
and fire precautions
Page 3 of 7
8
Horses
8.1
How many horses are kept under the
terms of the Act at the present time?
8.2
How many horses is it intended to keep
under the terms of the Act during the
year?
Please provide details of all the horses currently kept
8.3
Name of horse
8.4
Description including size
8.5
Sex
8.6
Age
8.7
Horse passport number
8.8
Purpose for which horse is kept
8.9
Age range of people who ride this horse
8.10
Are there other horses, donkeys, etc? If
‘yes’, provide the information required in
8.3 to 8.9 for all other horses on an
additional sheet (provided on page 6)
Yes/No
9
Management of the establishment
9.1 Name and address of the manager/person with direct control of
the establishment
9.2 Does the manager have any of the following certificates? (tick all that apply)
Assistant Instructor’s Certificate of the British Horse Society
Intermediate Instructor’s Certificate of the British Horse Society
Instructor’s Certificate of the British Horse Society
Fellowship of the British Horse Society
Fellowship of the Institute of the Horse
None of the above
9.3 Please give details of the manager’s experience in the
management of horses
9.4 Does a responsible person live at the establishment? Yes/No
9.5 What are the arrangements in the event of an emergency?
9.6 Will a person who is under 16 years of age be left in charge of the
establishment at any time?
Yes/No
9.7 Will a responsible person (of 16 years or over) provide
supervision at all times while horses from the establishment are
used for riding instruction or are hired out for riding (except in the
case of the hirer being competent to ride without supervision)?
Yes/No
Page 4 of 7
10
Veterinary surgeon
10.1 Name of usual veterinary surgeon
10.2 Company name
10.3 Address
10.4 Telephone number
10.5 Email address
11
Public liability insurance
11.1 Do you have public liability insurance?
Yes/No
If ‘no’, go to question11.9
If ‘yes’, please provide details of the policy
11.2 Insurance company
11.3 Policy number
11.4 Period of cover
11.5 Amount of cover (£5 million minimum required)
Does this policy:
11.6
Insure against liability for any injury sustained by those who hire a horse from
you for riding and those who use a horse in the course of receiving instruction in
riding, provided by you in return for payment?
Yes/No
If ‘yes’ to all,
go to 12.1
11.7
Insure against liability arising out of such hire or use of a horse?
Yes/No
11.8
Insure such hirers or users in respect of any liability which may be incurred by
them in respect of injury to any person caused by, or arising from, such hire or
use?
Yes/No
11.9
Please state what steps you are taking
to obtain such insurance
12
Disqualifications and convictions
Has the applicant, or any person who will have control or management of the establishment, ever been
disqualified from:
12.1
Keeping a pet shop?
Yes/No
12.2
Keeping a dog?
Yes/No
12.3
Keeping an animal boarding establishment?
Yes/No
12.4
Keeping a riding establishment?
Yes/No
12.5
Having custody of animals?
Yes/No
12.6
Has the applicant, or any person who will have control or
management of the establishment, been disqualified or
convicted of any offences under the:
Animal Welfare Act 2006
Animal Welfare (Scotland) Act 2006
Dangerous Dogs Act 1991
Any other legislation listed in Schedule 8 of the LAIA
Regulations 2018?
Yes/No
12.7
Has the applicant, or any person who will have control or
management of the establishment, ever had a licence
refused, revoked or cancelled?
Yes/No
12.8
If ‘yes’ to any of these questions, please provide details
Page 5 of 7
13
Additional details
Please check local guidance notes and conditions for any additional information which may be required
13.1
Add
itional information which is required or may be
relevant to the application
Standard payment and declaration section
14
Payment
14.1
Payment must be made at the time of making the application
14.2
Confirm date payment of fee made and
how made e.g. online Include reference
number
15
Statutory guidance
All applicants to tick that they have read the applicable statutory guidance and conditions
15.1
Selling of Animals as Pets
15.2
Boarding of Cats
15.3
Boarding of Dogs
15.4
Dog Day Care
15.5
Home Boarding of Dogs
15.3
Exhibition of Animals
15.4
Hiring Out Horses
15.5
Breeding of Dogs
16
Additional information
Please attach the following Information - ALL INFORMATION IS REQUIRED
16.1
A Basic DBS (Dated within 3 months of
the application date)
16.2
Right to Work (Passport, Birth
Certificate, ID Card or Home Office
Document)
16.3
Proof of Planning Permission
(including GBC Reference number)
16.4
A plan of the premises
16.5
Insurance policy (minimum £5 million)
16.6
Standard operating procedures
16.7
Emergency response plan
16.8
Infection control procedure
16.9
Qualifications
16.10
Training records
16.11
Other documents may be required
specific to the type of activity
Page 6 of 7
17
Declaration
17.1
This section must be completed by the applicant. If you are an agent, please ensure this section is completed
by the applicant.
17.2
I am aware of the provisions of the relevant Act, Regulations and Statutory Guidance.
The details contained in the application form and any attached documentation are correct to the best of my
knowledge and belief.
I understand that a person authorised by the Council will inspect the premises before a licence is issued.
I understand that a person authorised by the Council may inspect the premises either by appointment or
unannounced at any reasonable time.
I understand that a person authorised by the Council may take photographs or video footage whilst carrying out
inspections or visits to the premises.
I am aware that a fee is payable for this licence application.
I accept that all veterinary fees incurred by the authority in respect to the licence application will be recoverable
at cost.
I accept that in the event of my application being refused or I withdraw it, I will not be refunded the application
fee or any part thereof under any circumstances.
I apply under the above legislation for a licence to carry on the activity of hiring out horses at the above
premises.
I accept that on occasion the Council has to provide information to third parties in response to requests made
under the Environmental Information Regulations 2004, Data Protection Act 1998 and Freedom of Information
Acts.
17.3
Signing this box indicates you have read
and understood the above declaration
17.4
Full name
17.5
Capacity
17.6
Date
The information you provide on this form will be used by Guildford Borough Council for licensing purposes. We may share
your information and make any other necessary enquiries regarding your application with other departments and statutory
organisations in relation to the application. Your personal information will be processed in line with Data Protection
legislation and we will not disclose information about you to anyone outside the Council unless the law permits or requires
us to. We will retain your data for as long as it is required for our administrative use, after which it will be securely
disposed of. If you believe the data we process on you is incorrect you may request to see this information and, if
necessary have it corrected or deleted. If you wish to raise a complaint you can contact our Data Protection Officer at the
address below. If you believe we are processing your data lawfully you can complain to the Information Commissioner’s
Office (https://ico.org.uk/). Further details are available on our website – https:// www.guildford.gov.uk/dataprotection, or
from the Information Rights Officer, Guildford Borough Council, Millmead House, Millmead, Guildford, Surrey, GU2 4BB
(email: foi@guildford.gov.uk
).
click to sign
signature
click to edit
Page 7 of 7
Additional Information
8.3
Name of horse
8.4
Description including
size
8.5
Sex
8.6
Age
8.7
Horse passport
number
8.8
Purpose for which
horse is kept
8.9
Age range of people
who ride this horse
8.3
Name of horse
8.4
Description including
size
8.5
Sex
8.6
Age
8.7
Horse passport
number
8.8
Purpose for which
horse is kept
8.9
Age range of people
who ride this horse
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2020.02.14 RIAMS Hiring Out Horses Application Form Hiring out of horses licence application form - Eastbourne Borough Council

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Completed 7 July 2020

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