Domestic Animal Waiver of Rabies Vaccination Form

Vaccinating domesticated animals against rabies protects the individual animal against a virtually 100% fatal disease.  Modern rabies vaccines are considered very safe and have low incidence of adverse effects.  It is strongly encouraged by the Town of Stony Plain that rabies vaccinations are obtained for domestic animals; however, this form may be used as a waiver of the rabies vaccination requirement as per Section 1.4.4 of the "Responsible Pet Ownership Bylaw" (2566/AC/16).  Hereinafter referred to as the "Bylaw".

Protection of Privacy - The personal information requested on this form is collected under the authority of Section 33 (c) of the Alberta Freedom of Information and Protection of Privacy Act and will be protected under Part 2 of that Act.  It will be used for the purpose of completing the Domestic Animal Waiver Vaccination Form.  If you have any questions regarding the collection, use, and disclosure of personal information, please contact the FOIP coordinator at 780-963-2151.

By signing this form, I, , acknowledge the below statements (initial required after each point):

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