PERFORMING ANIMALS (REGULATION) ACT 1925
FORM OF APPLICATION FOR REGISTRATION
I, the undersigned, do hereby apply for registration under the Performing Animals (Regulation) Act 1925, and do hereby declare the following particulars to be true and complete to the best of my knowledge and belief.

Address to which Certificate of Registration is to be sent		Signature		
		Name		
		Date		

PARTICULARS

1	Full name of applicant, surname first in block capitals		
2	Stage name (if any) used in Great Britain 		
3	Nationality		
4	Either (a) address or fixed place of residence in Great Britain, or (b) permanent postal address in Great Britain from which letters addressed to applicant will be forwarded		
5	Address or addresses (if any) in Great Britain, other than temporary addresses while on tour, at which applicant trains or intends to train performing animals (if none, write “None”)		
6	State whether previously registered under the Act. If so, state name of local authority by whom registered and number and date of certificate of registration		
7	Kinds of animals proposed to be trained or exhibited, stating the number of each kind	(a) Trained	(b) Exhibited	
		Kind	No.	Kind	No.	
						
NB Particulars of the general nature of the performance are to be given overleaf in accordance with the directions printed there	
PARTICULARS
8	Describe briefly the general nature* of the performance or performances in which the animals are to be exhibited, or for which they are to be trained, mentioning any apparatus which is used for the purpose of the performance.	
		
	* The description must be sufficient to give a general idea of what is to be done by the animals taking part in the performance and should state the approximate duration of the performance, the number of times for which it is usually to be given in one and the same day and the number of animals of each kind taking part in the performance. It need not give details which would divulge any professional secret.	

Note:
The fee payable in respect of the registration of a person under the Act is £30 and should be made payable to Worcestershire County Council and remitted with the application.

Worcestershire Trading Standards
Wyre Forest House
Finepoint Way,
Kidderminster
DY11 7WF

Tel: 01905 822799