Horse interested in purchasing _________________________________ Your Name _____________________________ I am over 18 years of age: yes ___no___ Address _______________________________________________________ City _________________________________ State __________________ Zip Code _______________ Email ___________________________ Home Phone Number ____________________ Place of employment__________________ Work Number __________________ Cell Phone Number __________________ 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?
Will the horse be boarded?
Will the horse be at your farm?
If boarded other than at the above address, state name and address of facility: Name of Stable or Farm__________________________________________Address_______________________________________________________ City, State, Zip_________________________________________________ Phone Number_________________________________________________ Contact:_______________________________________________________ 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:
Rate your experience (circle one on each line): Riding: Very Experienced Intermediate BeginnerHorse Care: Very Experienced Intermediate BeginnerI will seek the guidance of an experienced trainer:
Name, phone and fax of your equine veterinarian for a reference: ______________________________________phone______________fax____________ *****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.
Name of your farrier for a reference: _______________________________________phone______________fax____________ Describe the type of fencing the horse will be turned out in: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 Other
What is the size of the turn out area (circle one)? Under an acre Under 2 acres Under 5 acres Under 10 acres Over 10 acres Is there a run in shelter?______ How many horses (besides the CANTER horse) will share it?______ Is it a dirt turn out or grassy pasture?___________ Will the horse be pasture boarded only?
If stalled, how many hours a day will the horse be turned out versus in a stall? Will the horse have its own stall? What is the size of the 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?
Indicate your intended use for the horse (circle one): Non-riding companion Light trail riding Western pleasure 4H or light showing Trail riding Light jumping Dressage Hunter/Jumper/Eventing
Do you have hands on experience in caring for a broodmare and foaling? _____________ If you ever intend to breed this horse, please complete the following: What purpose do you intend to breed for?
Please explain breeding experience:
Other_______________________________________________________ A Lifetime Conditional Bill of Sale will be required to be signed. The horse may never race again. Follow up farm visits will 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?
Do you understand and agree to 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? If so, explain:
I acknowledge that inaccurate or false statements made on this Prepurchase Approval Questionnaire may void this sale at a later date. 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. Signature of Purchaser:_____________________________________ Dated:____________
Please Return one of the following ways: By regular mail to CANTER Ohio, 3967 Karl Road, #228, Columbus, OH 43224. Or Cut and Paste into an email to canterohio@canterusa.org Click
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