Adoption application

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Pony Up Rescue for Equines PO Box 1023 Olalla, WA 98359 EIN#26-4237505 Adoption application I understand that this is only an application and that the filling out of this form implies no guarantee of approval to adopt. Pony Up Rescue for Equines reserves the right to deny any application for any reason. I understand that an adopting party enters into a contractual agreement with Pony Up Rescue for Equines to provide a home for the equine for as long as Pony Up Rescue for Equines feels that the adoption is in the best interest of the equine. I further understand that adopted equines may not be sold or traded or given away or placed into another person s care without the expressed written consent of Pony Up Rescue for Equines. I understand that if I am no longer able to care for the equine, the equine must be returned to Pony Up Rescue for Equines and transportation must be arranged. Please be advised that each equine is adopted with an adoption donation. The donation amount depends on several factors including age, ability, condition, level of training and care requirements. A signed adoption agreement and donation must be received in order for this agreement to be finalized and the ownership of the equine transferred to the adopting party. Please indicate the horse you are interested in: Adopter information: Name: Address: Age: How long at present address: Home phone: Cell phone: Email address: Employer name:

Address: Household income: Has anyone in your household been convicted of the following: Domestic violence: Animal cruelty or neglect: Drug abuse or selling of illegal pharmaceuticals? Horse ownership history: Do you currently own a horse or horses? how many: Please list: Ages: Equine living arrangements: Board: Own property: Will the equine live on your property? If boarding, please provide the name, address and phone number of the facility you plan to board with: - Describe the type of run in, corral, stall or loafing shed the equine will live in: What type of fencing does the facility or your property have: Under what circumstances do you stall a horse?

What is your deworming protocal? How often do you have a farrier out for hoof maintenance: How often will you have the horse s teeth examined? Knowledge of basic horse care: For what reasons would you call your vet? List signs of colic: What are some of the sudden causes of lameness: What is laminitis? And what would be your first clue to noticing the start of it? References: Veterinary: phone Do we have permission to call your vet for references? Personal Reference: 1. phone 2. phone Adopter/Rider Experience Who will ride the horse?

How would you describe their ability? Experienced? Limited experience? inexperienced? rides with trainer? How long has rider been riding/working horses? Planned use of horse? dressage jumping trail Responsibility of care: How often do you feed? What type of feed? Water source? How many hours a day will horse be turned out? Before you submit this application, have you thought about the expense of owning a horse? Below are some examples of the costs of horse ownership. We have found that a typical equine costs about 4,000 a year to support adequately. Hooves shod or trimmed 70-150 dollars Grain/hay 250-300 a month Wormer every six weeks.4-12 dollars Annual vet visits 300+ Annual teeth floating 125-300 dollars At least 1-2 hours each day to feed, clean stalls and grooming. Misc expenses such as fly spray, shampoo, grooming items Funds for any emergency vetting such as colic hospitalization or leg injuries or flu from 1000-3000 dollars. If a horse becomes ill and requires medical attention, this can range from a simple vet call and exam for 150 dollars or could reach into the thousands for something such as colic surgery.

Our goal is to adopt horses to lifelong homes where their emotional, physical, social and medical needs are met. What will you do if your horse becomes unsound or unfit for riding? Signed and dated: *I attest to the above information being true and correct. adopter* date: witness date: