| Date: |
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| First Name: |
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| Last Name: |
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| Address Street 1: |
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| Address Street 2: |
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| City: |
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| Zip Code: |
(5 digits) |
| State: |
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| Daytime Phone: |
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| Evening Phone: |
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| Email: |
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| Directions to the address the horse will live. |
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| Will the horse be pastured or stalled?: |
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| What type of horse are you interested in adopting? |
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If undecided, please explain what qualities you are looking for in a horse
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| Please list the reason(s) you want to adopt a horse:: |
Check any that apply
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Companionship |
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Gift |
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To Breed |
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To Trail Ride |
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To Show or Compete |
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For a Child |
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For Grass or Weed Control in Pasture |
| Other (Please Describe): |
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| Who will be responsible for the horse? |
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| Do you own the land that you intend to keep the horse on? |
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| If renting, owners name and phone number? |
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| Do you own your home? |
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| If renting landlords name and phone number? |
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| Do you have children? |
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| Do they live in your home? |
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| How many and what ages? |
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| Do any of your family members have allergies to animals? |
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| If so please explain:: |
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| When you go on vacation, who will care for your horse? |
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| Do you anticipate moving soon? |
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| If so where and when? |
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| Are you currently enlisted in the military? |
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| If so what branch? |
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| If you are moving what will you do with your horse? |
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| Please explain:: |
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| Do you have experience with horses? |
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| If so please explain your experience and how long: |
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| What type of pets have you owned in the last 5 years? |
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| If yes, please list age, gender, is it spayed or neutered? Where is it now? |
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| Who will be your veterinarian (name address and phone number)? |
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| Who will your farrier be (name phone number)? |
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| Please give your estimate of what it will take to care for a horse per year |
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| What type of fencing do you currently have for a horse? |
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| Have you ever adopted a horse before?: |
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| Have a heart horse and animal rescue requires everyone adopting one of our horses to agree in writing NOT to breed the adopted horses. Do you have any reservations about this? |
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| Do you understand horses require a series of vaccinations each and every year? |
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| Do you agree to vaccinate every year? |
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| In our contract Have a heart horse and animal rescue requires anyone adopting one of our horses to agree in writing NOT to give, sell, or trade the adopted horse for any reason. The adopted horse must stay with the adoptive family's custody or be returned to Have a heart horse and animal rescue. Do you agree to this requirement? |
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