Adoption application

Horse Interested in Purchasing:

Name: 

I am over 18:

Email:

Address:

City and State:

Zip Code:

Home Telephone:

Place of Employment:

Work Phone:

Cell Telephone:

Best time to call:

Do you understand that this is a racehorse off the track and has only had racing training and that they need an experienced rider and someone capable of retraining them as riding horses?

Yes  No

Explain:

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

If No, Please Explain:

Will the horse be boarded?

Yes  No

Will the horse be at your farm?

Yes  No

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:

Rate your experience (select one on each line): 

Riding

Very Experienced  Intermediate  Beginner 

Horse Care

Very Experienced Intermediate  Beginner 

I have experience in working with horses recently off the track

Yes  No

I will seek the guidance of an experienced trainer

Yes  No

Name and phone of your trainer:

Leave this blank if you do not have a trainer.

Name:

Phone:

Name and fax of your equine veterinarian for a reference:

*****THIS MUST BE COMPLETED OR YOUR APPROVAL WILL NOT BE PROCESSED. Contact is made with your reference 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 on an approval, please contact your vet to find out if they have responded to our reference check. 90% of all approval delays are due to the lack of vet responses.

Vet Name:

Vet Phone:

Vet Fax:

Name and phone of your farrier for a reference:

Name:

Phone:

Describe the type of fencing the horse will be turned out in: (Please check all that apply)

Wood 3 or 4 board rail

Vinyl or plastic coated board fence

Vinyl fence (5 inch wide style or rolled)

Split rail

Wire farm fencing (graduated squares)

Strand high tensile wire on t-posts on wood posts

Distance between posts:

Other

What is the size of the turn out 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

Size of run

How many horses will share it besides the CANTER horse?

Will the horse have a Stall?

Yes  No

Size of stall

Is it a dirt turn out or grassy pasture?

Will the horse be pasture boarded only?

Yes  No

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

Number hours turned out:

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

Explain:

Indicate your intended use for the horse (select all that apply):

Pasture/Non-riding Companion Only
Light Trail Riding
Western Pleasure 4H or light showing
Western Performance

Trail riding

Light jumping
Dressage
Hunter/Jumper/Eventing

Breeding (If you check this box, you must fill out the breeding questions below.)

Other

If you ever intend to breed this horse, please complete the following:

What purpose do you intend to breed this horse for?

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

Please explain breeding experience:

A Lifetime Conditional Bill of Sale will be required to be signed. The horse may never race again. Follow up farm visits may be performed. Although you are allowed to sell, lease or transfer a CANTER Owned Horse, the Lifetime Conditional Bill of Sale is for the lifetime of the horse and new owners are bound by the conditions of this bill of sale. The Lifetime Conditional Bill of Sale requires, among other things, that CANTER be provided with a right of first refusal in the event of transfer of this horse and approval and notification in writing of the new owner.

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

Yes  No

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

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?  If so, explain.

Yes  No

Explain:

Additional info:

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 a buyer 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 Purchaser:

Date: