Foster/Adoption Application form

How did you hear about Double D?

Are you interested in receiving our updates on Events?

Are you interested in volunteering?

Full Name *

First Name Last Name

Age

E-mail *

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Phone Number - Home

Area Code Phone Number

Phone Number - Cellular

Area Code Phone Number

Phone Number - Work

Area Code Phone Number

Please List all People Living in the Household (Include Name, Relationship, Gender and Age) *

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Contact Person

First Name Last Name

Phone Number

Area Code Phone Number

Email

example@example.com

Name

First Name Last Name

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number

Area Code Phone Number

Email

example@example.com

This is a :

New Vet A Vet I've Been Using

Name

First Name Last Name

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number

Area Code Phone Number

Please Indicate the Person's Profession

Farrier Trainer Riding Instructor Breeder

Name

First Name Last Name

Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number

Area Code Phone Number

List Names in order of preference:

What do you plan on using the equine for?

How much time do you plan on spending with this equine?

How often each week and for how long do you plan on riding this equine?

Please list names and ages of everyone that will be riding this equine.

How many equines do you currently have?

Have you had horses in the past?

If yes, please tell us what they were used for and why you do not have them now:

Describe your experience with handling, caring for, riding, and/or training equines:

How often do you worm horses?

How often do you feel you have horse's teeth floated?

How often do you have horse's feet trimmed?

What is your opinion on shoeing a horse?

Who will be feeding the equine?

How often do you plan on feeding the equine?

How often do you plan on having a Ferrier trim or shoe the equine?

How often do you plan on worming the equine?

How often do you plan on having a veterinarian see the equine?

Do you plan on keeping the equine in:

Barn or other shelter Pasture

If the equine will be kept in a barn:

What size are the stalls?

How often and how long will they be turned out?

If the equine will be kept in the pasture/paddock, how many other equines will be in the pasture/paddock?

Type and Size of shelter in the paddock/pasture?

Type of fencing surrounding the paddock/pasture?

Please describe any debris in the paddock/ pasture such as limbs, metal, glass, trash, etc.

Do you have plans on removing said debris? If not, please explain why.

Confidentiality Statement:
I, the undersigned, understand that certain information pertaining to Double D Animal Rescue and Community Services,
may be confidential in nature and that I am to use discretion in discussing policies, current cases and other related
issues.
Acknowledgement:
I, the undersigned, understand that I am applying to adopt/foster an equine from Double D Animal Rescue and
Community Services (herein referred to as Double D). I understand that I must complete the application procedure and
have the equine property or boarding facility inspected and approved before being allowed to adopt/foster an equine
from Double D. I understand that I may not be able to adopt/foster the equine I’m interested in for various reasons.
In addition, I understand that Double D Animal Rescue and Community Services may perform a background check to
verify my personal information as well as check for any criminal convictions.
By signing this application, I agree that I have read and understand the Adoption and/or Foster policy of Double D. I
understand that I must submit a complete application in accordance with the policies before being considered as an
adoptive and/or foster applicant. I understand that if I adopt/foster an equine from Double D I will be subject to followup visits in accordance with the Equine Follow-Up Policy. I also understand that, in accordance with the Adoption
and/or Foster Policy, I may never sell, give away, lease out, send to auction or send to slaughter, etc. the equine I
adopt/foster. I also understand that I may never use the equine for breeding purposes. I also agree that Double D is
not liable in the event of injury, death, or damage to any human, animal, or property as a result of activities or actions of
the equine I adopt/foster.
I further agree to accept all responsibility for any action or lien resulting from any action, directly or indirectly
involving said equine(s) while it is in my care. Therefore, I agree and understand that neither Double D Animal Rescue
and Community Services nor its employees or agents will be liable for any damages or injury caused to me or any
third person by the equine(s) once I receive delivery of it, including but not limited to damages or injuries caused by
the fact that the equine(s) does not behave or perform in the manner I expected. Further, if any third person makes a
claim against Double D Animal Rescue and Community Services or any of its employees or agents as a result of any
conduct of the equine(s) in my possession, I agree to indemnify and hold Double D Animal Rescue and Community
Services, its employees and agents harmless from any such claim, including costs and attorney’s fees resulting from
such claim.
Every effort has been made to disclose the history of these equines AS WE KNOW IT. These are rescued equines, and in
some circumstances we may have little or no knowledge about the equine’s prior life or training. We will tell you
everything we know about the equine, however, we cannot make any guarantees about an equine’s temperament or
training. It is advised that the adopter pay for a vet check prior to adopting any equine.
I have read and accept the terms, conditions and above-stated
regulations that pertain to my acceptance and placement of the equine.

Signature

Clear

Have you ever been charged with or convicted of animal abuse?

Yes No

If yes, please explain:

The following information is required for a criminal background check. Please enter your date of birth.

Date

Please Note: Applications will be processed and property inspections conducted within 3-4 weeks of receipt of
the application. Final approval depends on the property inspector’s expeditious return of the inspection
worksheet and photographs to the Director responsible for final approval of the equine property.

Equine Property Location

Contact Person

Required Vet Reference Information

Equine Professional Reference

Adoption Applicants

Equine Experience