Surrender Form

Surrender Form
If you are considering surrendering your horse to the Kentucky Equine Adoption Center, please complete the Surrender Form below. Once submitted, our team will review the information and contact you to discuss your horse and next steps.

Please note that we can only accept horses located within the state of Kentucky.

We typically have a waiting list, and the process may take anywhere from a few days to several months. We encourage you to keep this in mind as you plan.
- Name*
  
  First NameLast Name
- Address*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- Email*
  example@example.com
- Phone Number*
  Please enter a valid phone number.Format: (000) 000-0000.
- Driver's License #*
- Driver's License State*
- Name Of Equine*
  If you are inquiring to surrender multiple equines, please fill out a separate form for each.
- Breed*
- Age*
  If this is an estimated age please note.
- Sex*
- Where is the equine located?*
  
  Street Address
  
  Street Address Line 2
  
  CityState / Province
  
  Postal / Zip Code
- YesNo
- If registered, please state registered name and what association it is affiliated with.
- If registered, please upload a copy of registration papers.
  
  Cancelof
- If applicable, please provide registration number.
- If applicable, please provide tattoo or brand.
- YesNo
- If microchipped, please provide microchip number.
- How long have you owned this equine?*
- What was this equine's previous use?*
- If equine has been ridden in the past, please describe riding/training history. *
- Please explain the situation that led you to consider surrender.*
- YesNoUnknown
- If you answered yes to the question above, please provide details.
- YesNoUnknown
- If you answered yes to the question above, please provide details.
- YesNoUnknown
- If you answered yes to the question above, please provide details.
- YesNoUnknown
- If you answered yes to the question above, please provide details.
- What is your horse currently eating and the amount each day? Any supplements?*
- YesNoUnknown
- If you answered yes to the question above, please provide details.
- Please describe the equine’s temperament, vices, and any other habits about which the Kentucky Equine Adoption Center, Inc. and its adopters should know.*
- YesNo
- If you answered yes to the question above, please provide details.
- YesNo
- If you answered yes to the question above, please provide details.
- YesNo
- YesNo
- YesNo
- If you answered yes to the question above, please provide details.
- Please list dates of equine’s last vaccinations, worming, hoof and dental care. If unknown, please type "unknown"
- E & W Encephalomyelitis*
- Tetanus*
- Rhino/Flu*
- Rabies*
- West Nile*
- Botulism*
- Dewormer*
- Farrier*
- Dental*
- Please provide a copy of current coggins. *
  
  Please note, all horses entering The Kentucky Equine Adoption Center must have an up to date negative coggins.
  Cancelof
- YesNo
- If you have a current health certificate, please provide a copy.
  
  Cancelof
- Anything else we should know that was not mentioned above?
- Any other documents we should have that were not provided above?
  
  Cancelof
- Please provide at least one photo of the equine. *
  
  Cancelof
- Additional photos or videos can be provided below.
  
  Cancelof
- I agree
- Signature*
  
  Powered by Jotform SignClear
- I agree
- Signature*
  
  Powered by Jotform SignClear
- If accepted, I hereby surrender the below named equine(s) to the Kentucky Equine Adoption Center, Inc., and thereby relinquish all ownership of the equine(s). I represent and warrant I have the right to deliver the equine(s) to the Kentucky Equine Adoption Center, Inc. I understand that the Kentucky Equine Adoption Center, Inc. will not be responsible for any financial obligations incurred by the owner(s) on behalf of this equine(s) prior to its surrender to the Kentucky Equine Adoption Center, Inc. By signing below, I waive any waiting period before disposition of the equine(s). Should the Kentucky Equine Adoption Center, Inc. find a suitable home for the equine(s), I understand that I am consenting to adoption of the equine(s) by an individual/organization as determined appropriate in the Kentucky Equine Adoption Center, Inc.’s sole discretion. I understand and agree that I am transferring full ownership of the equine(s) to the Kentucky Equine Adoption Center, Inc. and the Kentucky Equine Adoption Center, Inc. has full authority for all necessary veterinary procedures.*
  
  I agree
- Signature*
  
  Powered by Jotform SignClear
- I acknowledge that necessary veterinary procedures may include a veterinarian’s determination that euthanasia is appropriate given the equine’s physical and/or mental condition. Having given full consideration to the terms of this agreement, and understanding my obligations and waivers pursuant thereto, I have decided to relinquish the equine(s) to the Kentucky Equine Adoption Center, Inc., and agree to all terms of this agreement by signing below.*
  
  I agree
- Signature*
  
  Powered by Jotform SignClear
- There is no fee to surrender a horse; however, we do appreciate donations. A suggested donation of $250-$500 will cover the intake exam and any diagnostic testing that needs to be done.
- Donation
  
  prevnext( X )
  USD
  
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