Heart of Illinois Horse Rescue, 14681 Toad Hill Road, Wapella, IL 61777

Phone:  (217) 433-6388     www.https/:heartofillinoishorserescue.net

e-mail:  heartofillinoishorserescue@gmail.com

ADOPTION APPLICATION

Adoption Application and Checklist (please read carefully)

Adopters must be 18 years of age, be employed, financially and personally stable, have horse experience or a plan to learn about horses, the desire for a life-long companion, a long term plan for the horse, have the quality time to spend with your horse, the time and money for the required daily care of your horse and approved facilities to house your horse.

 Adopter’s personal information:

Adopter’s full name:                                                                                                                Date of birth:

Address (St., Rd., City, State, Zip Code)                                                                                                                 

# of years at this residence :                                                                Phone #’s:  cell/work        

Do you own the place you will keep your horse?                 

If no, where will you be boarding your horse?                                                         

Name of Stable:        

Stable Owner(s) Name:                                                     

Address of Stable:        

Stable Phone Number:                  

Stable Website and/or e-mail address:        

 Have you ever been accused of, charged with or convicted of a crime of fraud, theft, inhumane treatment of animals, spouse/child abuse or killed a domestic animal?            

If yes, please describe the offense, the date, county and state, and the outcome of the case:                                                                                                                                                                                                                                                                                                                                                                                                                

 Adopter’s Occupation:                                                                                                          

Employer/Company Name & City of Employment:                                                                                                                                         

How many years have you been employed with this company/employer?                         

 

Horse Owner Experience

            Have you ever owned horses?               If yes, how many horses have you owned                

         How many horses do you own now?         How many years have you owned horses?            

  How many hours per week do you spend with your current horse(s)?                                

            How would you describe your level of horsemanship?

                        Beginner           Intermediate               Advanced                 

                        Why?                                                                                                                         

                                                                                                                                                           

     If you already have a horse(s), why do you want another horse?                                                     

                                                                                                                                                           

            Which of our adoptable horses are you interested in and why?                                           

                                                                                                                                                            

                                                                                                                                                                 

            Are you looking for a rideable horse, pasture companion or untrained horse?                

            How much riding have you done in the last year?                           

            What types of riding have you done? (trail, arena, show, jumping)                                     

  What is your contingency plan for taking care of your horse if you should have to be out-of-town, on vacation or sick?

                

Describe the barn where you will keep your horse; such as size of stall, size of barn, pasture acreage:        

            Turn-out if Stall Board:  How many days/hours outside?  Days:        Hours in Day:            

            Turn-out with other horses?  YES                 NO                  If yes, how many horses?           

 

Adopter and the Adoption Horse

What type of riding do you plan to do with your horse? (if competing or showing,  describe the competition, level jumping, riding discipline, how often and at what level the primary rider is competing at now):                                                                                     

                                                                                                                                                           

            What is the most important characteristic you are looking for in a horse (color, breed, sex,       age, size, temperament, training level, riding discipline?)                                                                                                                                                             

                                                                                                                                                            

 

            How many hours per day maximum will your horse be ridden or worked per day?                       

            Approximate hours per day can you spend with your horse? Summer           Fall          Winter           

            If you have a horse trainer, please include the name and phone #:                                      

                                                                                                                                                           

            Before riding your horse, do you do any prep work such as lunging, grooming, etc.?           

                                                                                                                                                            

References

Veterinarian’s name/location/phone# (if you have never had an equine vet, you can list your other type of vet):                                                                                                                                  

                                                                                                                                                            

Farrier name/phone #:                                                                                                                                    

(If you don’t have a farrier currently, you can list a possible farrier you will use)

 

Horse-related reference (someone who knows you and your horses – no family please)

            Name:                                                                Phone:                                               

Any other additional information that you would like to share:                                                                                                              

                                                                                                                                  

                                                                                                                                  

            

Statements of Understanding

1.  I have completely read the adoption contract and promise to abide by all clauses, including going to see the adoption horse, riding the horse before adoption, vet checks, giving the horse   time to settle in to its new home, payment of the adoption fee, returning the horse, and the  annual updates required.  I have the required facilities, the desire to have a life-long          companion, the financial capability, the mental, physical, family stability and the time required to commit to the above tasks for the life of this horse and everything required to keep a horse in good health and provide a good quality of life for the horse,  I understand that horses may live between 28-40 years and this is a life-long commitment to this horse.

2.  I understand that there is an adoption fee for all adoptions payable at the time of the transference of the horse to the adopter.  I understand that none of the adoption fees are ever reimbursed, even if I decide I can’t take the horse or must return the horse, regardless of any reason.  I understand that horses adopted from Heart of Illinois Horse Rescue includes no guarantee regarding training level, soundness, temperament or general condition of the horse.  As an adopter I assume full responsibility for any person injured, property damaged or death caused by an adopted horse in the adopter’s care, and agree to hold harmless and indemnify Heart of Illinois Horse Rescue and its representatives do not know everything about every horse, regardless of how long the horse has been with Heart of Illinois Horse Rescue.

 3.  I understand it is my responsibility to know my limitations regarding time, money, knowledge and riding ability prior to adopting and I will be truthful and forthright in my preference for an adoption horse.  I understand that much of the selection of the horse is related to undefined selling of both the adopter and the horse, much like picking a spouse or mate.  You need to meet to see if you click.

 4.  I promise that this application is true and factual and I understand that any false statements can result in immediate removal of all the adoption horses from my facility and can also resut in legal action against the adopter in a civil court by Heart of Illinois Horse Rescue and its legal representative.  I have read and understand the adopter’s adoption contract and agree to abide all rules and regulations of the adoption contract.  I understand that if the Heart of Illinois Horse Rescue Board of Directors have any concerns or there are any discrepancies in my application that a decision to do a formal background check that includes credit, work, residential, farm visits, police check, civil and criminal check.  I understand that any intentional falsification of your application will be considered fraud.

 5.  I understand that the rights and obligations of the parties hereto shall be subject to and be construed and interpreted under the laws of the state of Illinois.  The parties hereto shall consent to  jurisdiction and venue of the court of Illinois for all purposes and for any disputes arising under this agreement.  If for any reason the Heart of Illinois Horse Rescue moves from Illinois the adopter will accept the jurisdiction of the state and county of which the rescue resides.  If the event that the Heart of Illinois Horse Rescue dissolves, I understand another horse rescue will pick up the management of facilitating this contract and tracking the horse for life and that the Heart of Illinois Horse Rescue will contact me if this happens.  The dissolution of Heart of Illinois Horse Rescue in no way releases the adopter from fulfilling this contract.

 

                                                                                                                                                            

Print Full Name of Adopter                                       Signature                                            Date

 Thank you for considering adopting one of our horses.  Heart of Illinois Horse Rescue is committed to finding safe, permanent homes for all our horses.  Every year thousands of horses are transported to slaughterhouses in Mexico and Canada where they endure a horrifying death.  The inhumane treatment of these horses is what has prompted the organization of our rescue.  You are quite literally saving a life and we praise you for your willingness to complete our application to give a horse a loving home. Thank You!

 Pamela Barnes, President, Heart of Illinois Horse Rescue

 

Heart of Illinois Horse Rescue, 14681 Toad Hill Road, Wapella, IL   61777

Phone:  (217) 433-6388     www.https/:heartofillinoishorserescue.net

e-mail:  heartofillinoishorserescue@gmail.com

ADOPTION CONTRACT

This contract is entered into on this               day of                                     ,                        between Heart of Illinois Horse Rescue, a 501(c)(3) non-profit organization (hereinafter referred to as HOIHR) and                                                                                                                 (hereinafter referred to as “Adopter.”)

The Adopter agrees, in accordance with the terms and conditions set forth in this Agreement, to adopt and care for the horse known as                                                           (hereinafter referred to as “Said Horse.”)

HOIHR agrees to transfer ownership of Said Horse to the Adopter subject to the conditions set forth in this agreement.  The Adopter understands that a non-refundable adoption fee in the amount of  $                                 and shall be made payable to Heart of Illinois Horse Rescue in the form of cash or money order.  The adoption fees are nonrefundable and must be paid in full on or before the day of delivery/pickup of Said Horse.  The Adopter agrees to pay the cost of transporting Said Horse to its new facility.

The Adopter agrees to pay for the cost of any pre-purchase professional evaluations or veterinary exams contracted for by the Adopter.  The Adopter will, at his or her expense, care for Said Horse in a responsible and humane manner. HOIHR guidelines for care of Said Horse include, but are not limited to:  adequate feed (hay, pasture and horse feed), shelter, turnout, worming, farrier, veterinary and dental care.  If Adopter adopts a male colt too young to be gelded at the time of adoption, the Adopter will consult with Adopter’s veterinarian as to when colt can be gelded and Adopter agrees to pay the veterinarian for said gelding of adopted colt.

The Adopter promises to NEVER allow Said Horse to be sold, leased or given away to anyone for any reason.  The Adopter agrees that if he or she is unwilling or unable to care for Said Horse for its entire lifetime, he or she will contact HOIHR and return Said Horse to a designated location specified by HOIHR. The Adopter understands that he or she is responsible for the care of Said Horse until he or she has delivered it to HOIHR and will do everything within his or her power to safely return Said Horse. In addition, Adopter agrees not to allow Said Horse to enter onto any racetracks for the purpose of running in a horse race of any kind. 

Adopter understands that Said Horse will have a current copy of Said Horse negative Coggins Test exam, all known veterinary and dental records provided by HOIHR at the time of the transfer of ownership.  Adopter also understands that Said Horse will need updated vaccinations, coggins test, worming, dental care and routine farrier care. 

Adopter understands that many of the conditions of Said Horse are not obvious and HOIHR cannot know all of the details of Said Horse’s medical, physical or mental history.  The responsibility for determining if Said Horse is fit for use by Adopter belongs solely to Adopter.  The Adopter acknowledges that Adopter has been advised by HOIHR to engage the services of a licensed veterinarian and an experienced horseperson prior to adoption to evaluate Said Horse.  Adopter agrees to accept Said Horse as is and where is. 

Adopter allows HOIHR to publish pictures and progress reports of Said Horse in written and/or electronic form. 

Adopter agrees to hereby indemnify and hold HOIHR and its officers, directors, and volunteers harmless from and against any and all claims, actions, damages, liability and expense in connection with the loss of life, personal injury, and/or damage to property arising out of the use of care of Said Horse.  Adopter is hereby given notice that pursuant to Illinois law 745/ILCS 4/25(b) that under said Equine Liability Act, each participant who engages in an equine activity expressly assumes the risk of engaging in and legal responsibility for injury, loss, or damage to person or property resulting from the risk of equine activities.  

Adopter agrees that should it become obvious that Said Horse is suffering due to a terminal illness or injury that Adopter shall contact a licensed equine veterinarian to determine if euthanasia is deemed necessary for the health and welfare of Said Horse.  Adopter agrees that it is determined that euthanasia will end Said Horse from suffering a painful life to pay the expense of the procedure.  Adopter agrees that in the event of the death of Said Horse either by natural causes or euthanasia, Adopter will notify  HOIHR of death of Said Horse.  In the event, Adopter fails to adhere to any of the aforementioned contract conditions and Said Horse becomes neglected or abused in the opinion of an independent professional, this agreement becomes null and void and Said Horse will be immediately and voluntarily returned to HOIHR at the expense of the

Adopter’s Signature:                                                                                                                Date:              

HOIHR Representative Signature:                                                                                                                    Date: