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Horse:_____________________ Date:___/___/___
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SECOND CHANCE FOR HORSES ADOPTION FORM
OFFER TO ADOPT (description, or name of horse):
Name:
Email Address:
My Telephone #
Cell Phone #
Address:
Employed by Title
Address__________________________________Telephone_________
How long with this company?______
Drivers License#:_______________________ State:
REFERENCES:
1._________________________________________________________
Telephone__________________
2._________________________________________________________
Telephone__________________
3._________________________________________________________
Telephone__________________
Please circle.
I currently own a horse / burro.
I have / have not owned a horse / burro.
I will board this animal at the above residence yes / no
If no, Location of boarding facility____________________________________
The boarding facility is ________ miles from my residence.
Telephone ______________________ Business hours ______________
The type of corral, or stall, which will be provided
is:_________________________________________ (size___________)
The daily feeding will be done by __________________.
The training will be done by _________________________ Telephone _____________
The equine veterinarian who will care for this animal is:
Address_________________________________ Telephone__________
PLEASE READ THE FOLLOWING CAREFULLY. BY SIGNING IT YOU MAY BE GIVING UP RIGHTS THAT YOU MIGHT OTHERWISE HAVE.
I will have a veterinarian examine the horse once each year and follow any recommendations the veterinarian feels are necessary. I will be solely responsible for all expenses for this examination.
If this offer is accepted by Second Chance for Horses Rescue, I agree that said animal shall reside with the minimum corral space of three hundred (300) square feet, with sanitary living conditions, constructed of wood or pipe, with shelter from the elements and will be provided with inoculations as recommended by the veterinarian. I understand and agree that said animal may not be sold for slaughter, abused, mistreated or neglected, and that if I am proved in violation of any of the above, I shall be subject to legal action. I agree that an authorized representative of Second Chance for Horses Rescue may enter the property where said animal resides to determine if all conditions of this agreement are being complied with. I further offer that should I violate any of these terms an authorized representative of Second Chance for Horses Rescue may enter upon the land where said animal resides, and take immediate possession of said animal.
I further agree to accept all responsibility for any action or lien resulting from any action, directly or indirectly involving said animal once it is in my care. Therefore, I agree and understand that neither Second Chance for Horses Rescue nor its employees or agents will be liable for any damages, or injury caused to me, or any third person, by the animal once I receive delivery of it, including, but not limited to, damages, or injuries caused by the fact that the animal does not behave, or perform in the manner I expected. Further, if any third person makes a claim against Second Chance for Horses Rescue or any of its employees, or agents, as a result of any conduct of the animal after I have taken possession of it, I agree to indemnify and hold Second Chance for Horses Rescue, its employees, and agents harmless from any such claim, including costs, and attorney's fee resulting from such claim.
Additional Requirements or Waivers (Must be approved by Second Chance for Horses Rescue.)
Second Chance for Horses Rescue ID Number or description of Adopted animal:
The above offer is accepted by Second Chance for Horses Rescue.
Signed_________________________________________
Date________
The above offer is accepted by Adopter.
Signed_________________________________________
Date________
