It is the goal of Days End Farm Horse Rescue, Inc. (DEFHR) to attempt to place each horse in the home best suited to the needs of the individual horse. In addition, horses adopted from DEFHR cannot be used for breeding, resold or given away. The horse cannot be relocated from the original approved facility without the permission of DEFHR. In the event that the placement does not work out for any reason, DEFHR requires that the horse be returned to DEFHR. Before any horse may be adopted from DEFHR the following procedures must be followed: 1. The adoption questionnaire must be completed and signed along with this cover letter and returned to DEFHR. 2. Upon review and approval of the adoption questionnaire, by an official of DEFHR, the prospective adopter will be contacted by DEFHR to schedule an appointment for a formal interview and a tour of DEFHR facilities. 3. If the personal interview is satisfactory and if DEFHR has a potentially suitable horse at that time, DEFHR will schedule an appointment to check out the adopter's facility. In addition, DEFHR will also conduct interviews of the references provided by the potential adopter on the adoption questionnaire. 4. Upon completion of the above, DEFHR will schedule working sessions with the potential horse and the adopter to determine if it is a suitable match. 5. Upon completion of the sessions it will be determined whether or not the potential horse and adopter are compatible. DEFHR may require at any time additional sessions, may approve final adoption and/or deny adoption. DEFHR reserves the right to deny adoption for any reason in its sole discretion, and is not obligated to state any reason. When all requirements are met and preliminary adoption procedures have been satisfied, DEFHR will require the following at the time of adoption: 1. Completion of a permanent adoption contract, with such terms and conditions as DEFHR may, in its sole discretion, determine. 2. Payment in full of a non-refundable adoption fee which is based upon each individual horse, and set by DEFHR in its sole discretion. (unless payment arrangements have been made previously) 3. Should alternate payment arrangements have been agreed to previously this contract must be signed and installment amount be paid. 4. Upon final adoption of the horse, DEFHR reserves the right to transport the adopted horse to the adopters facility for a nominal fee. 5. DEFHR reserves the right to conduct unscheduled follow-up checks on the adopted horse and the facility at DEFHR's discretion. Upon placement of a horse, the adopter is required to submit an annual health statement from the adopter's veterinarian and farrier. Thank you very much for contacting DEFHR and we look forward to hearing from you soon. Sincerely, Kathleen Schwartz, President DEFHR I have read and understand the above procedures. ____________________________________ _______________________ Potential Adopter Date NAME OF HORSE: _________________ DATE: _________________ DAYS END FARM HORSE RESCUE ADOPTION QUESTIONNAIRE Name: _____________________________________ Home Phone: _________________ Address: __________________________________ Work Phone:__________________ City / State: _____________________________________ Zip: _________________ Previous Address: ______________________________________________________________ Employer:_____________________________________________________________________ Annual Income: _______________________________________________________________ 1. Do you ? Rent _____ Own _____ Live with Parents _____ Landlord's Name: _____________________________________________________________ Landlord's Phone: ____________________________________________________________ 2. Will the horse be kept on your property? ______________________________ With other horses? _____ If yes, describe the area and shelter provided: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ If no, list the address and description of boarding/training facility: ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Manager/Trainer: __________________________ Phone: _________________________ Facility Phone: _____________________ Hours of operation: __________________ DEFHR Adoption Questionnaire Page 2 3. Do you own a horse now? _____ How many? _____ Description: ______________ If you have previously owned horses, please describe briefly what happened to them: ______________________________________________________________________________ ______________________________________________________________________________ 4. What type of horse are you specifically interested in? ____________________ ______________________________________________________________________________ ______________________________________________________________________________ Age: ________________ Breed Preference: _____________________________________ Range of Training: ___________________________________________________________ Approximate height of rider: _________ Weight; _______________________________ 5. Briefly describe your level of expertise in the following areas: Riding: ______________________________________________________________________ ______________________________________________________________________________ Handling: ____________________________________________________________________ ______________________________________________________________________________ Training: ____________________________________________________________________ ______________________________________________________________________________ Working with young or unbroken horses: _______________________________________ ______________________________________________________________________________ 6. Who will ride the adopted horse? __________________________________________ DEFHR Adoption questionnaire Page 3 7. Which member of your household will be responsible for the feeding? _______ ______________________________________________________________________________ Training? ____________________________________________________________________ General care of the horse? ___________________________________________________ Their level of expertise? ____________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ 8. How much do you anticipate spending yearly for feed? ______________________ Medical care? ______________ Worming? _________________ Trims? ______________ 9. How often do you feel a horse should be wormed? ___________________________ Hooves trimmed? _________________ Teeth Floated? ____________________________ What type of vaccinations should a horse receive? ____________________________ ______________________________________________________________________________ 10. Please tell us why you would like to adopt a horse? ______________________ ______________________________________________________________________________ ______________________________________________________________________________ 11. If you move in the future what will you do with this animal? _____________ ______________________________________________________________________________ ______________________________________________________________________________ 12. Who will care for this animal when you go on vacation? ___________________ ______________________________________________________________________________ DEFHR Adoption Questionnaire Page 4 13. If you own an animal now, who is your veterinarian? ______________________ Phone: ______________________ Farrier: _________________ Phone: _______________ If not , who will be your veterinarian? ______________________________________ Phone: _________________ Farrier: _________________ Phone: _________________ 14. Have you ever been issued a warning/citation for humane violations? _______ If so, please explain disposition: ____________________________________________ ______________________________________________________________________________ 15. Please indicate when it would be convenient for us to do a property/Barn check: ______________________________________________________________________________ 16. Please provide three references: Name: _________________________________________ Address: _________________________________________ _________________________________________ Phone: _________________________________________ Name: _________________________________________ Address: _________________________________________ _________________________________________ Phone: _________________________________________ Name: _________________________________________ Address: _________________________________________ _________________________________________ Phone: _________________________________________ 17. I/We certify that all the information contained herein is true and correct. Signature: ______________________________________ Date: _______________ Signature: ______________________________________ Date: _______________