CANTER New England Printable Approval Form

We thank you for taking an interest in our program and for taking the time to provide the information necessary for approval as an adopter and/or foster home. We strive to make you happy with your CANTER horse, as well as to find a permanent and loving home for each of our horses.

Once approved, you will be notified by e-mail or telephone. Your approval will be valid for any horse CANTER owns that meets your intended use. You must notify us if your contact information on file should change (this includes a new e-mail address, street address, or phone number). You must submit a new application if your stabling location and/or veterinarian change.

Please note: CANTER NE does not generally adopt horses out to homes beyond the New England/New York area. Please contact the CANTER affiliate closest to you if you are not in our adoption vicinity.

Please tell us some information about your experience and the facility where the horse will be stabled. Prospective adopters will need to complete ALL questions.

Once completed you can fax or mail this form:

Fax to: 617-507-8358 OR

Mail to: CANTER NE, P.O. Box 3, Westborough, MA 01581

Horse Interested in Adopting:	___________________________________
Name:	___________________________________
I am over 18:	Yes No
E-mail:	___________________________________
Address:	___________________________________
City and State:	___________________________________
Zip Code :	___________________________________
Home Telephone:	___________________________________
Place of Employment :	___________________________________
Work Telephone:	___________________________________
Cell Telephone:	___________________________________
Best Time to Call :	Day Evening Anytime

I am seeking to be approved as a:	Foster Home Adopter Both
If you answered "both", are you looking to adopt a horse now or to simply foster?
Do you understand that this is a racehorse off the track, has likely had only racing training, and that the horse will need an experienced rider and someone capable of retraining him/her as a riding horse?	Yes No
Please explain your understanding of a racehorse's training and what you believe will be required in order to successfully transition the horse as a riding horse:
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:	Yes No
Intended use:
Please indicate what you intend to use your CANTER horse for (check all that apply):	Pasture/Non-riding Companion Only Trail Riding Western Pleasure 4H Western Performance 4H - Pony Club Endurance Light Showing (English and/or Western) Light Jumping Dressage Hunter/Jumper/Eventing/Competition Other If Other, please explain. Breeding (If breeding, please answer the following questions: What purpose do you intend to breed this horse for? Do you have hands on experience in caring for a broodmare and foaling? Yes No Please explain your breeding experience:
Horse Stabling
Where will the horse be stabled?	Boarding Facility My Farm
State name and address of facility where horse will be boarded: (You must fill this out even if it is the same address from above!)
Name of Stable or Farm:	___________________________________
Address:	___________________________________
City, State, and Zip:	___________________________________
Phone Number:	___________________________________
Contact Name:	___________________________________
Facilities
Describe the type of fencing the horse will be turned out on? (check all that apply)	Wood 3 or 4 board rail Vinyl or plastic coated board Vinyl fence (5 inch wide style or rolled) Split rail Wire farm fencing (graduated squares) Strand high tensile wire on t-posts Strand high tensile wire on wood posts For strand wire on any post, please state the number of strands, what is the height of the fence, and the distance between the posts. Other ` If other, please describe:
What is the size of the turnout area (select one)?	Under an acre Under 2 acres Under 5 acres Under 10 acres Over 10 acres
Is there a run-in shelter?	Yes No If yes, what are the dimensions of the shelter?
How many horses (besides the CANTER horse) will share the turnout space?	___________________________________
Is the turnout dirt or grass?	Dirt Grass
Will the horse be pasture/field boarded or will it be on full board and have a stall?	Pasture Full Board with Stall
If stalled, how many hours a day will the horse be turned out verses in a stall?	___________________________________
When first introduced to other horses, the new horse must NOT be suddenly turned out with them. Is there a separate over fence paddock or pasture that can be used until the horse is acquainted with others?	Yes No If no, please explain:
Horse Experience
Rate Your Riding Experience:	Advanced Intermediate Beginner
Rate Your Horse Care Experience:	Advanced Intermediate Beginner
I have experience working with horses recently off the track:	Yes No
I will seek the the guidance of an experienced trainer:	Yes No
If no, please explain:
Name and phone number of your trainer (leave this blank if you do not have one):
Trainer's Name	___________________________________
Trainer's Phone Number	___________________________________
Veterinarian
THIS MUST BE COMPLETED OR YOUR APPROVAL WILL NOT BE PROCESSED. Contact is made with your veterinarian by fax. 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 CANTER horse. You should tell them that CANTER, the racehorse placement program will be contacting them by fax. DO NOT supply the vet phone number as the fax number unless they are the same number. Forms with incorrect fax numbers will not be processed! If you haven’t heard back about your approval status within a week, please contact your vet to find out if they have responded to our reference check fax. 90% of all approval delays are due to the lack of vet responses.
Vet Name:	___________________________________
Vet Phone:	___________________________________
Vet Fax:	___________________________________
Farrier
Farrier Name:	___________________________________
Farrier Phone:	___________________________________
Lifetime Conditional Bill of Sale Adoption Agreement
A Lifetime Conditional Bill of Sale Adoption Agreement must be signed. The horse may never race again. Follow-up farm visits may be performed. Although you are allowed to sell, lease or transfer an adoptively placed CANTER horse after a 12-month period, the Lifetime Conditional Bill of Sale Adoption Agreement remains in effect, without exception, for the lifetime of the horse, and all future new owners are bound by the conditions of this agreement. The Lifetime Conditional Bill of Sale Adoption Adoption Agreement requires, among other things, that CANTER be provided with a right of first refusal in the event of transfer of this horse, and that any new owner of the horse must be approved in writing by CANTER before leaving the current adopter's care.
Do you intend to transfer the ownership of this horse after retraining?	Yes No
Do you understand and agree to the conditions that will be in the Lifetime Conditional Bill of Sale Adoption Agreement?	Yes No
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?	Yes No If yes, please explain:
Additional Information
Is there any additional information you would like CANTER to know about you when considering your application?
Acknowledgement
I acknowledge that inaccurate or false statements made on this Adoption Questionnaire 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 a foster home or as an adopter is not guaranteed by completion of this form, that it is subject to CANTER's sole discretion and that it may be withdrawn should the circumstances, upon which my approval was based, change.
Name/Signature of Applicant:	___________________________________
Date:	___________________________________
Click here when you finish printing to read more about adding an ex-racehorse to your family!