Adoption Application

Applicant Info

Check each that applies*

Adoption Applicant
Foster Applicant

First Name*

Last Name*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Home Phone*

Work Phone*

Cell Phone*

Email*

Would you like to receive our newsletter?*

Yes, please!
No, thank you.

Would you like to receive information on how to become a volunteer?

Yes, please!
No, thank you.

How did you hear about us?

Current Employer

Years with this employer

Employer Address

Annual Income

Alternate Contact Information (needs to be a family member not in the same household )

First Name

Last Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Email

Home Phone

Cell Phone

Work Phone

Equine Property Location

If the equine will be kept someplace other than the address listed above, please provide the name of the facility, address, contact person and phone number:

Required Reference Information

Indicate if your are:*

Currently using this vet
This is a new vet

Equine Veterinarian Reference's Name

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Equine Professional Reference's Name

Phone

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Indicate Profession

Farrier
Trainer/riding instructor
Breeder
Other

Equines you are interested in

List name of equines you are interested in.

What do you plan on using this equine for?*

How much time per week do you plan on spending with the equine?*

If the equine is rideable, how often each week and for how long do you plan on riding?*

Equine rider description

If you will be using the equine for riding, please list the names, ages, height, and weight of everyone that will be riding:

Current Equine Information

How many equines do you currently have?

Date of last vaccination

Vaccinations received

Date the equine(s) were last dewormed

What product was used?

Date of last negative Coggins

Equine Experience

If you currently do not have any equines have you previously owned and if so for how long?

In the past five years, have you given away or sold any equines? Please explain

In the past five years, have you had any equines pass on while in your care? Please explain

Describe your experience with handling, caring for, riding, and/or training equines.

Who will be feeding the equine?

How often do you plan on feeding the equine?

How often do you plan on having a farrier trim or shoe the equine?

How often do you plan on worming the equine?

How often to you plan on hav ing a veterinarian visit the equine?

Will the equine be kept in a barn or pasture?

If the equine is in a barn, what size are the stalls?

If the equine is in a barn, how often and how many hours will they be turned out?

If the equine will be kept in pasture, what size is the paddock/pasture?

How many other equines are in the paddock/pasture?

Type and size of shelter in the paddock/pasture?

Type of fencing surrounding the paddock/pasture?

Describe any debris in the paddock/pasture such as limbs, metal, glass, trash, etc

Do you have plans to remove said debris?

If not please explain

Confidentiality Statement

I, the undersigned, understand that certain information pertaining to Habitat for Horses, Inc. may be confidential in nature and that I am to use discretion in discussing policies, current cases and other related issues with non-members. I also understand that it is my privilege as a member to be party to certain email lists, and that no email messages that I receive from these lists may be forwarded to anyone not belonging to that list without first obtaining permission from a member of the Board of Directors. I have read, understand, and agree to adhere to the statement outlined herein.

Acknowledgement

I, the undersigned, understand I am applying to adopt/foster an equine from Habitat for Horses (hereinafter referred to as HfH). I understand that I must complete the application procedure and have the equine property or boarding facility inspected and approved before being allowed to adopt/foster an equine from HfH.
I understand that I may not be able to adopt/foster the equine I am interested in for various reasons. In addition, I understand that HfH may perform a background check to verify my personal information as well as check for any criminal convictions.
By signing this application, I agree that I have read and understand the Adoption and/or Foster Policy of HfH. I understand that I must submit a complete application in accordance with the policies before being considered as an adoptive and/or foster applicant. I understand that if I adopt/foster an equine from HfH I will be subject to follow up visits in accordance with the Equine Follow Up Policy. I also understand that, in accordance with the Adoption and/or Foster Policy, I may never sell, give away, lease out, send to slaughter, etc. the equine I adopt/foster. I also understand that I may never use the equine for breeding purposes. I also agree HfH is not liable in the event of injury, death or damage to any human, animal or property as a result of activities or actions of the equine I adopt/foster.
I further agree to accept all responsibility for any action or lien resulting from any action, directly or indirectly involving said equine(s) while it is in my care. Therefore, I agree and understand that neither HABITAT FOR HORSES, INC. nor its employees or agents will be liable for any damages or injury caused to me or any third person by the equine(s) once I receive delivery of it, including but not limited to damages or injuries caused by the fact that the equine(s) does not behave or perform in the manner I expected. Further, if any third person makes a claim against HABITAT FOR HORSES, INC. or any of its employees or agents as a result of any conduct of the equine(s) in my possession, I agree to indemnify and hold HABITAT FOR HORSES, INC., its employees and agents harmless from any such claim, including costs and attorney's fee resulting from such claim. Every effort has been made to disclose the history of these equines AS WE KNOW IT. These are rescued equines, and in some circumstances we may have little or no knowledge about the equine’s prior life or training. We will tell you everything we know about the equine however, we cannot make any guarantees about an equine’s temperament or training. It is advised that the adopter pay for Vet Check prior to adopting any equine.

Date

Printed Name

Background Check

The following information is required for a criminal background check. All information will be protected as private and confidential:

Have you ever been charged with or convicted of animal abuse?

If yes, please explain.

Date of Birth

Please Note

Applications will be processed and property inspections conducted within 3-4 days of receipt of the application. Approval depends upon expeditious return of the inspection worksheet and photographs of the equine property to the office.

Why we are different…

Applicant Info

Alternate Contact Information (needs to be a family member not in the same household )

Required Reference Information

Current Equine Information

Equine Experience

Confidentiality Statement

Acknowledgement

Background Check

Please Note

Why should you adopt?

About Habitat for Horses

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