By signing and submitting this application form to NZTR:
1. I undertake that I have read the application form and that all of the information that I have provided to NZTR in, or with, it is true and correct in all material respects.
2. I acknowledge that the provision of any false, misleading or inaccurate information in, or with, this form may result in charges being brought against me under the NZTR Rules of Racing or otherwise, and may also result in the revocation of any licence issued to me.
3. I undertake and confirm that I meet all of the requirements for the issue of an Assistant Trainer Licence to me under the Rules of Racing.
4. I consent to the New Zealand Police disclosing to NZTR any information that they may have about me for the purposes of NZTR's consideration of this application. I understand that any record of criminal convictions I might have will be automatically concealed if I meet the eligibility criteria set out in Section 7 of the Criminal Records (Clean Slate) Act 2004.
5. I consent, for the purposes of Rule 656 of the NZTR Rules of Racing (if applicable), to providing a sample of one or more of my blood, breath, urine, saliva or sweat, as and when required by a Stipendiary Steward or Investigator, for the purposes of drug and alcohol testing.