Reality’s Chance Sanctuary
Equine Donation Contract
Donor Contact Information:
Name: ______
Address: ______
City, State, Zip ______
Home phone: ______Work Phone: ______
Email address: ______
Name of your veterinarian: ______
Veterinarian’s phone number: ______
May we allow potential adopters of the equine you are donating to contact you?
Will you act as a reference so that others wishing to donate equines may contact you to ask questions about your dealings with Reality’s Chance Sanctuary?
Equine Information
Name of equine you are donating: ______
Breed of equine you are donating: ______
Is the equine registered? If so, with what registry? ______
Registration number? ______
Color of equine: ______
Markings on equine: ______
Age: ______Height: ______Weight: ______Gender: ______
Name of Dam (if known): ______
Name of Sire (if known): ______
Is the equine microchipped? If so, whose name is the microchip information in?
______
Is the equine branded? If so, where and what is the brand?
______
Does the equine have a lip tattoo? If so, what is the tattoo? ______
Temperament (1-10, 1 = Very Quiet, 10 = Highly Spirited): ______
Friendliness towards adults (1-10, 1 = Nasty or Afraid, 10 = extremely friendly):_____
Friendliness towards children (1-10, 1 = Nasty or Afraid, 10 = extremely friendly):_____
Friendliness towards horses (1-10, 1 = Nasty or Afraid, 10 = extremely friendly):_____
Friendliness towards dogs (1-10, 1 = Nasty or Afraid, 10 = extremely friendly):_____
Can this equine be ridden by: (check all that apply)
_____ Notrideable: lameness or injury
_____ Notrideable: young age or lack of training
_____ Notrideable: ____ old age ____ Children at walk ____ Adults at walk
_____ light/medium riding
Has this equine been trained or had experience in: (CIRCLE all that apply)
Trail, Competitive Trail, Endurance, English Pleasure, Western Pleasure, Driving,Eventing, Jumping (how high?), Dressage, Youth Horse, Reining, Barrel Racing,General Western Riding, General English,
Other: ______
Is this equine currently suitable for or have the potential for: (CIRCLE that apply)Trail, Competitive Trail, Endurance, English Pleasure, Western Pleasure, Driving,Eventing, Jumping (how high?), Dressage, Youth Horse, Reining, Barrel Racing,General Western Riding, General English,
Other: ______
Describe any competitive experience this equine has:______
______
Has this equine ever: (check all that apply and explain if “yes”)
Bucked? ______Reared? ______Kicked? ______
Bitten? ______Other? ______
Is this equine easy to: (check all that apply)
Lead ___ Tie ___ Trailer ___ Clip ___
Describe any current or previous lameness problems: ______
Describe any current or previous health problems:______
______
Does the equine have any special needs? ______
Is the equine current on vaccinations? If so, which and when were they last administered?
______What is the date on the equine’s most current coggins test? ______
When was the last time the equine’s teeth were floated? ______
When was the last time the equine was wormed? ______
When was the last time the equine’s hooves were trimmed? ______
Does the equine get along with other equines? ______
In what kind of housing situation is the equine used to (pasture, stall, etc). ______
What and how much is the equine currently being fed? ______Is there anything else you can tell us about the equine that will enable us to help find him/her the best possible home?______
Why are you donating this horse to Reality’s Chance Sanctuary:
By signing this contract, I, the undersigned donor of the above described equine understand and agree to the following:
I am giving up all my rights, title, and interest in the above described equine to Reality’s Chance Sanctuary.
There are no liens or claims against the equine, and if any liens or claims are found, I will be solely responsible for them and will indemnify Reality’s Chance Sanctuary from all damages Reality’s Chance Sanctuary may suffer due to the initiation of legal proceedings brought against myself and/or Reality’s Chance Sanctuary arising from my former ownership of the above described equine.
I am releasing this equine completely and voluntarily.
I have read and fully understand the policies ofReality’s Chance Sanctuary and
realize that in the event the existing policies do not cover a specific situation, Reality’s Chance Sanctuary will use its best judgment and ability in handling the situation in the best interest of the equine.
I understand that once I release the equine, I will not have control over the equine’s care. I understand that Reality’s Chance Sanctuary will provide for the equine per their policies and in the event the existing policies do not cover a specific situation, Reality’s Chance Sanctuary will use its best judgment and ability in handling the situation in the best interest of the equine.
I understand that Reality’s Chance Sanctuary will not accept the equine until I
have signed and returned this contract, and have provided Reality’s Chance Sanctuary with a copy of the equine’s veterinary records from the previous twelve (12) months.
I understand that Reality’s Chance Sanctuary will not accept this equine without
a Negative Coggins test from within the last twelve (12) months.
I understand that Reality’s Chance Sanctuary may decline to accept the donation
of this equine at any time until the equine has been officially accepted into the rehabilitation or adoption program.
This contract is the complete and entire agreement between the parties and completely merges and supersedes all prior and contemporaneous oral or written discussions, negotiations, and agreements. No additions or modifications to or deletions from this Contract shall be effective
unless executed in writing by the parties, and attached to this Contract as an Addendum. Please note yes or no in the space provided whether an addendum is attached. ______(Any addendum is only valid if both the donor and Reality’s Chance Sanctuary sign and agree to the addendum).
By signing, I declare that the above information on the equine is true to the best of my knowledge.
______
Donor Signature Date
______
Reality’s Chance Sanctuary
Representative Signature Date