Claiming Pre-Authorisation Form

This is a pre-authorisation form only and does not constitute a claim. ALL claims must be made via the designated telephone line (045-455444) after the race as per Regulation 6.

Accounts seeking pre-authorisation should be in good standing and it is the discretion of the HRI Client Account staff to determine the standing.

Your Name

Race Venue

Designated Collector Name

Date of Birth (DD/MM/YYYY)

Phone Number (with area code)

Date of Race (DD/MM/YYYY)

Designated Collector Phone Number

HRI A/C No.

Designated Trainer

Max Pre-Authorisation Value

If making multiple claims, please select a value to represent all claims

I consent to being contacted by Horse Racing Ireland

I have read and agree with the terms of Regulation 6 and HRI’s privacy Notice.