Adoption Application

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Applicant Information

(all applicants must be 18 years of age or older)

First Name*

Last Name*

Street Address*

Address Line 2

City*

State*

ZIP Code*

Home Phone*

Work Phone*

Cell Phone*

Email*

Alternate Phone*

CDL#*

Adoption fees/donations help defray the costs of services pertaining to the adoption process and are non-refundable after the 30 days trial period per the terms of the Adoption Agreement.

How did you hear about Rescue Ranch?*

Equine Experience

How many horses do you currently have?*

Date of last vaccinations for your horse(s):*

Vaccines received:*

Date of last de-worming:*

What products were used?*

If you do not currently own a horse(s), have you previously owned any and if so, for how long?*

In the past five years have you have you given away or sold any horses? If yes, please explain.

In the past five years have you had any horse(s) pass away while in your care? If yes, please explain.

Please describe you experience with horses, handling, caring for, riding, and/or training, etc.:*

Will your adopted horse reside at the address stated in the Applicant Information?* Yes
No

If no, please provide the following information:

Facility Name

Facility Address

City, State, Zip Code

Contact Person

Facility Phone #

Facility Information
If your adopted horse will be kept in a barn, please answer the following questions:

Stall size

How often and how many hours will the adopted horse be turned out?

If your adopted horse will not be kept in a barn, please answer the following questions:

Size turnout area

How many other horses are in the same area?

Describe the type and size of shelter in paddock/pasture:

Describe the type of fencing surrounding the paddock/pasture:

Equine Care and Responsibility

Who will be feeding the adopted horse?*

Does this person have experience with horses?*

How often do you plan on feeding the adopted horse?*

How often do you plan on de-worming the adopted equine?*

What type of de-worming products do you plan to use?*

Please provide your farrier's name and phone number*

How often do you plan on having a farrier trim and/or shoe the adopted horse?*

Emergency Contacts

Please list a minimum of two contacts who live nearby that RR can reach in the event of an emergency in your absence. These individuals must be willing to allow a RR representative to inspect the facility and/or condition of the adopted horse.

Contact (relationship to applicant):*

Address:*

Phone:*

Alternate Phone:

Adoption Information:

Please list the name of the horse you are interested in adopting*

How do you plan to use the adopted horse?*

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

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

Please list each person's name, age, and riding level (1 = no experience to 10 = very experienced) of every person that will b riding the adopted horse:

Name:

Level:

References

Please provide the name and contact information for your current veterinarian or the veterinarian you plan to use for your adopted horse. Also, please provide two references (other than family members) who can verify your ability to provide proper care for the adopted horse.

Veterinarian*

Address*

Phone Number*

Name (personal reference 1)

Phone Number

Address

City, State, Zip Code

Name (personal reference 2)

Phone Number

Address

City, State, Zip Code

By signing this adoption application, I declare that I am 18 years of age or older and that all of the information submitted is the truth to the best of my knowledge, and if found to be fraudulent, I will be denied approval of adoption and could be held liable for any damages incurred by ResQue Ranch. I, the Adopter, agree that ResQue Ranch has permission to contact anyone named in this application as well as to conduct a general background check on me and my spouse (if applicable). I understand I will be notified if my application has been approved and, at that time, a site visit will be scheduled. An application does not become fully approved until a site visit has been conducted by a ResQue Ranch representative and is found to conform to ResQue Ranch's guidelines for safe horse keeping.

* required fields