EAST TEXAS HORSE RESCUE & SANCTUARY, INC.
12992 State Highway 21 East
Alto, Texas 75925
Adoption Application
(you must be 18 years of age or older to fill out this form)
Name________________________________________________________
Address______________________________________________________
City, State, Zip _________________________________________________
County _______________________________________________________
Phone number (____)___________________ Work (____)______________
Cell (____)___________________
E-mail address _________________________________________________
Driver lic. Number______________________State_____________________
Name of relative closest to you: ____________________________________
Relative Phone No.: _____________________________________________
Place of Employment:____________________________________________
How Long? ____________________________________________________
How many horses do you currently have?
Will the horse that you will be adopting be residing at this address? Y/N
If no, what is the address at which it will be residing:
Owner/Caretaker ______________________________ Phone ______________
Address _________________________________________________________
City, State, Zip ____________________________________________________
County __________________________________________________________
If in a rural area draw us a map on back.
Have you ever been convicted of animal abuse or neglect? _________ If yes, please tell
us more about the incident. ____________________________________________
Which horse are you applying to adopt?
Name _____________________ ETHR&S # __________
Do you have any experience caring for horses? Y N
Have you sold or given away horses in the last three years? Y N
If yes, please tell us more about the circumstances. __________________________
___________________________________________________________________
Have any horses in your care ever died from something other than old age? Y N
If yes, please tell us more about the death. _____________________________
_____________________________________________________________
Where will the horse be primarily kept ( barn, pasture):?
How often will equine be turned out if kept in stall?___________________________
If outside, will the horse have shelter? Y N
What is the type and size of the shelter? ___________________________________
What type of fencing do you have?_______________________________________
Will you be responsible for feeding of equine? ________________
If someone else, please list name. ____________________________
How often do you plan on feeding equine? _____________________
How often do you plan on having a farrier trim or shoe the adopted equine?
______________________________
How often do you plan on worming the equine? _________________
Are you a member of East Texas Horse Rescue & Sanctuary? Y N
If you are not, you will need to pay the membership fee along with this application. In doing
this you will become a member of East Texas Horse Rescue&Sanctuary for one year.
No adoption application will be processed until all letters of reference are received. After
all paperwork is received, you will be contacted to schedule an appointment for you to
come to our facilities to visit your equine.
I the undersigned understand that I am applying to adopt equines from ETHRS. I
understand that I must complete the application procedure and have my home or boarding
facility approved before being allowed to adopt any equine. I understand that I may not be
able to adopt from ETHRS for various reasons.
By signing this application, I agree that I have read and understand the adoption policies
of ETHRS. I also agree not to hold ETHRS liable in the event of injury, death or damage to
any human, animal or property as a result of any activities or actions of the equine I adopt.
I also understand that I am responsible for the daily care of adopted equine including but
not limited to cost of feed, hay, worming and other costs incurred in routine care of the
equine.
I agree that ETHRS may conduct inspection at any time they feel necessary. I agree to
notify ETHRS in advance in writing if the equine will be moved. I understand that if I move
the equine without prior written approval from an ETHRS officer that I will be in breech of
contract and ETHRS can immediately take possession of the equine.
In addition, I the undersigned have read and understand the following warning:
Warning:
UNDER TEXAS LAW (CHAPTER 87 CIVIL PRACTICE AND REMIDIES CODE) AN EQUINE
PROFESSIONAL IS NOT LIABLE FOR AN INJURY TO OR DEATH OF A PARTICIPANT IN
EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISKS OF EQUINE ACTIVITIES
________________________________________ _________________
(Applicant Signature) (Date)
Copyright © 2004 East Texas Horse Rescue & Sanctuary, Inc. 2004
12992 State Highway 21 East
Alto, Texas 75925
Adoption Application
(you must be 18 years of age or older to fill out this form)
Name________________________________________________________
Address______________________________________________________
City, State, Zip _________________________________________________
County _______________________________________________________
Phone number (____)___________________ Work (____)______________
Cell (____)___________________
E-mail address _________________________________________________
Driver lic. Number______________________State_____________________
Name of relative closest to you: ____________________________________
Relative Phone No.: _____________________________________________
Place of Employment:____________________________________________
How Long? ____________________________________________________
How many horses do you currently have?
Will the horse that you will be adopting be residing at this address? Y/N
If no, what is the address at which it will be residing:
Owner/Caretaker ______________________________ Phone ______________
Address _________________________________________________________
City, State, Zip ____________________________________________________
County __________________________________________________________
If in a rural area draw us a map on back.
Have you ever been convicted of animal abuse or neglect? _________ If yes, please tell
us more about the incident. ____________________________________________
Which horse are you applying to adopt?
Name _____________________ ETHR&S # __________
Do you have any experience caring for horses? Y N
Have you sold or given away horses in the last three years? Y N
If yes, please tell us more about the circumstances. __________________________
___________________________________________________________________
Have any horses in your care ever died from something other than old age? Y N
If yes, please tell us more about the death. _____________________________
_____________________________________________________________
Where will the horse be primarily kept ( barn, pasture):?
How often will equine be turned out if kept in stall?___________________________
If outside, will the horse have shelter? Y N
What is the type and size of the shelter? ___________________________________
What type of fencing do you have?_______________________________________
Will you be responsible for feeding of equine? ________________
If someone else, please list name. ____________________________
How often do you plan on feeding equine? _____________________
How often do you plan on having a farrier trim or shoe the adopted equine?
______________________________
How often do you plan on worming the equine? _________________
Are you a member of East Texas Horse Rescue & Sanctuary? Y N
If you are not, you will need to pay the membership fee along with this application. In doing
this you will become a member of East Texas Horse Rescue&Sanctuary for one year.
No adoption application will be processed until all letters of reference are received. After
all paperwork is received, you will be contacted to schedule an appointment for you to
come to our facilities to visit your equine.
I the undersigned understand that I am applying to adopt equines from ETHRS. I
understand that I must complete the application procedure and have my home or boarding
facility approved before being allowed to adopt any equine. I understand that I may not be
able to adopt from ETHRS for various reasons.
By signing this application, I agree that I have read and understand the adoption policies
of ETHRS. I also agree not to hold ETHRS liable in the event of injury, death or damage to
any human, animal or property as a result of any activities or actions of the equine I adopt.
I also understand that I am responsible for the daily care of adopted equine including but
not limited to cost of feed, hay, worming and other costs incurred in routine care of the
equine.
I agree that ETHRS may conduct inspection at any time they feel necessary. I agree to
notify ETHRS in advance in writing if the equine will be moved. I understand that if I move
the equine without prior written approval from an ETHRS officer that I will be in breech of
contract and ETHRS can immediately take possession of the equine.
In addition, I the undersigned have read and understand the following warning:
Warning:
UNDER TEXAS LAW (CHAPTER 87 CIVIL PRACTICE AND REMIDIES CODE) AN EQUINE
PROFESSIONAL IS NOT LIABLE FOR AN INJURY TO OR DEATH OF A PARTICIPANT IN
EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISKS OF EQUINE ACTIVITIES
________________________________________ _________________
(Applicant Signature) (Date)
Copyright © 2004 East Texas Horse Rescue & Sanctuary, Inc. 2004
