VICIn ForceRegulation
Gambling Regulations 2015
Sch 5Application to publish and use Victorian race fields
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Schedule 5—Application to publish and use Victorian race fields
Regulation 56
Application to Publish AND Use Victorian
Race Fields
I apply for approval to publish and use the following race fields information:
🞎 Victorian horse racing race fields
🞎 Victorian harness racing race fields
🞎 Victorian greyhound racing race fields
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DETAILS OF APPLICANT
Name of Applicant:
Address of Applicant:
Applicant's contact details:
State, Territory or Country where
Applicant is licensed to operate:
Trading names used by Applicant:
Applicant's ACN or ABN:
ADDITIONAL INFORMATION
[*Insert any additional information required by the appropriate controlling body under section 4.2.3B(2)(c) of the* ***Gambling Regulation Act 2003***.]
CERTIFICATION
I certify that I am authorised to make the application on behalf of and that the information provided is true and correct.
Signature of authorised representative:
Name of authorised representative:
Date:
Sch. 6 amended by S.R. Nos 111/2016 reg. 9, 121/2023 reg. 18.