Horse Interested in Adopting

Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Place of Employment

Best Time To Call

I understand the financial obligations to maintain a healthy horse and I am capable of doing so without sharing those financial obligations with another party through lease or otherwise being dependent on them. *

Do you have hands on experience in caring for a broodmare and foaling?

Please explain your breeding experience.

Where will the horse be stabled *

Name of Stable or Farm, Address and Contact Name

Contact Phone Number

(###)

###

####

Please Describe Your Fencing. (Acreage, size of turnout area, type of fence, distance between poles)

Is there a run shelter?

What are the dimensions of the shelter and how many horses will share it?

Will the horse be pasture/field boarded or will it be on full board and have a stall?

If stalled, how many hours a day will the horse be turned out verses in a stall?

Rate your riding experience.

Rate your horse experience.

** THIS MUST BE COMPLETED OR YOUR APPROVAL WILL NOT BE PROCESSED.** Contact is made with your Veterinarian YOU MUST call your veterinarian and advise them that you are putting them down as a reference and that you want to be approved to purchase a horse with us. You should tell them that we will be contacting them.

Veterinarian Name and Phone number,

Farrrier Name and Phone number,

A Lifetime Conditional Bill of Sale will be required to be signed. Follow-up farm visits may be performed. Although you are allowed to sell, lease or transfer your Horse, the Lifetime Conditional Bill of Sale is for the lifetime of the horse and new owners are required to sign a form acknowledging the conditions of the Bill of Sale. The Bill of Sale also requires that Impact Eqine be provided with a right of first refusal.

Do you intend to transfer the ownership of this horse after retraining?

Do you understand and agree to the conditions that will be in the Lifetime Conditional Bill of Sale?

Have you ever sold a horse to a horse dealer that buys and sells at auctions or have you ever sold a horse through an auction?

Is there any additional information you would like us to know about you when considering your application?

I acknowledge that inaccurate or false statements made on this Adoption Questionaire may void this sale at a later date. The information I am submitting is true and filling out the following boxes will act as my signature. I also acknowledge that my approval as an adopter is not guaranteed by completion of this form, Impact Equine's sole discretion and that it may be withdrawn should the circumstances, upon which my approval was based, change. Please type your name below to acknowledge.

Thank you! We will be in touch with you soon.

Impact Equine On Line Adoption Application