Golden Hills Ranch
Equine Rescue and Rehabilitation, Inc.
P.O. Box 632
Aguanga California 92536
Adoption Application
You must be at least 18 years of age
Golden Hills Ranch Equine Rescue and Rehabilitation, Inc. reserves the right to refuse adoption if Golden Hills
Ranch Equine Rescue and Rehabilitation, Inc. deems the horse and adopter are not a suitable match.
Failure to complete will delay or deny your application. Please feel free to attach addition information about you
and the kind of horse your looking for to expedite your application.
Applicant Contact Information
Applicants Full Name______________________________________________________
Street Address____________________________________________________________
City_______________________________ State/Zip_____________________________
Home Phone________________________ Work Phone___________________________
Cell Phone_________________________ Alternative Phone______________________
Email Address____________________________________________________________
Would you like to be put on our email list YES/NO (this will not effect you either way)
Are you 18 years of age or older? Yes/No Your Date of Birth and Age_________________
Drivers License number_________________________ State_______________________
We do not adopt horses to anyone under the age of 18. A parent or guardian must be the adopter and except full
responsibility. You will be asked to show proof.
Application Experience (circle or fill in the blanks)
1. Is this your first horse? Yes/No
2. Do you or have you ever owned horses in the past? Yes/No
3. How many do you current own? __________
4. How many horses have you owned in the past 5 years? ________
5. Have you have ever owned horses in the past, the reason they are no longer with you?
____________________________________________________________________
__________________________________________________________________________________________
______________________________________________________
6. Have you ever surrendered or donated a horse to a rescue? Yes/No
7. What other type of animals do you own?_____________________________________
________________________________________________________________________
8. Do you own property where the adopted equine will be kept or will you be boarding?
Own/Rent/Boarding
If boarding (skip this part if your not boarding)
A. Name and location of facility.________________________________________
B. Facility address___________________________________________________
C. Contact person Name______________________________________________
D. Facilities phone number____________________________________________
E. What size stall?___________________________________________________
F. How many hours per day will the horse be in the stall?____________________
G. Does the stall have a run attached? Yes/No
H. What is the turn out schedule?_______________________________________
I. How many horses are turned out at the same time?________________________
J. Are mares and gelding turned out together? Yes/No
9. How many other horses are on your property?_______________________________
10. Will the horse be fed separately from the other horses? Yes/No
11. How many fenced acres or will you have access to a turn out area?_______________
12. What kind of shelter will be available?_____________________________________
13. Please describe the type of fencing, size of pasture, barn and/or shelter that will be provided to the adopted
equine.______________________________________________
________________________________________________________________________
14. Describe your horses preventative healthcare and maintenance program.
A. Deworming program_______________________________________________
B. Vaccination schedule_______________________________________________
C. Farrier__________________________________________________________
D. Feed____________________________________________________________
Current and Previous experience with horses (circle or fill in the blanks)
(On a separate piece of paper you may write your experience with horses current and previous, this doesn’t have
to be perfect we are not grading you, let us know about you and what your looking for.)
15. Who will be handling and/or riding the horse?_______________________________
16. Do you or they have experience training horses? Yes/No
17. If yes, please describe.__________________________________________________
__________________________________________________________________________________________
______________________________________________________
18. If you have little or no training experience, do you have someone that is willing to help? Yes/No Who?
______________________________________________________
19. Have you ever had riding lessons? Yes/No How long and where?_______________
________________________________________________________________________
20. What is your riding ability? (circle one)
Beginner: New around horses, comfortable riding at a walk, limited-no horse care knowledge.
Advanced Beginner: Comfortable at walk trot, limited knowledge, but can recognize signs of illness.
Intermediate: Comfortable at all gaits, can handle horses that test rider, able to treat minor wounds.
Experienced: Comfortable handling difficult horses in various environments and situations.
Very Experienced: Previous experience training horses and/or in handling green horses.
21. Have you ever purchased a horse from an auction? Yes/No
22. Have you ever sold a horse at auction? Yes/No
23. Have you ever adopted a horse before? Yes/No
If yes, from where?___________________________________________________
How did the adoption work out?_________________________________________
Do you still have the horse? Yes/No If no, explain_________________________
________________________________________________________________________
24. Please provide the name and phone number of your current (or one you intend on using)
Large animal vet______________________________________________________
Farrier______________________________________________________________
25. Your equine preference (circle or fill in the blanks)
Breed:_____________________________________________________________
Size: 10-12hh 12-14hh 14-16hh 16-17hh
Color:_____________________________________________________________
Gender: Mare Gelding Stallion Colt Filly
Age: (an older horse is highly recommended for the beginner rider)_____________
Training: Ride Drive Green Untrained No preference
26. Will you accept a horse with limitation? Yes/No
27. Will you accept a companion (non or light riding) horse? Yes/No
28. What type of riding and activities do you plan to do with your adopted horse? (check all that apply)
English____ Western____ Pleasure/Trail____ Showing____ Dressage____ 4-H____ Roping/Barrels____
Hunter/Jumper____ Driving____ Endurance/Competitive Trail___
Occasional____ Other______________________________________________________
29. Have you ever heard of natural horse training? Yes/No
30. Have you used natural horse training techniques? Yes/No
If yes, which method(s)?_______________________________________________
31. Have you ever attended a horse clinic, workshop or seminar? Yes/No
If yes, please list them_________________________________________________
________________________________________________________________________
We highly recommend if you haven’t heard of this or have never been to a clinic you go. Its fun and you learn by
seeing exactly how its done and you meet some really nice horse type people. There are books at your local book
store and available online.
32 Please provide us two references, not related to you, that have information about your capability to care for an
adopted horse. You references could be your veterinarian or trainer, a friend or neighbor.
(1)
Name___________________________________________________________________
Address_________________________________________________________________
Phone number____________________________________________________________
Relationship to Adopter____________________________________________________
(2)
Name___________________________________________________________________
Address_________________________________________________________________
Phone number____________________________________________________________
Relationship to Adopter____________________________________________________
In submitting this form you agree to and understand the following.
I, _____________________________________, certify that I have no prior violations or convictions of inhuman
treatment of animals nor do any family members in my household.
By signing below, the applicant hereby authorizes an officer or repetitive of Golden Hills Ranch Equine Rescue and
Rehabilitation, Inc to contact the references contained herein and also agrees to permit an officer or repetitive of
Golden Hills Ranch Equine Rescue and Rehabilitation, Inc to conduct a property inspection of the premises where
the adopted equine will be kept. Further, the undersign certifies that the information contained in the foregoing
application is true and correct to the best of his/her knowledge.
Golden Hills Ranch Equine Rescue and Rehabilitation, Inc retains the right to unilaterally seize the horse upon our
determination that said horse is not being properly cared for, including neglect, physical abuse or mental abuse. If
a adopted horse is found to be abused or neglected, we will prosecute to the fullest extent of the law following the
recovery of the horse.
If for any reason you are unable to continue your possession of the horse, it must be returned directly to Golden
Hills Ranch Equine Rescue and Rehabilitation, Inc and no refund will be given for either adoption fee or any
expenses incurred since adoption.
As an owner you agree to provide proper care and ongoing maintenance of the horse, to include, but not limited to
year round shelter, free access to clean water, proper feed, inoculations, dental care, hoof care, worming and
veterinary care.
New Owner take full responsibility for the safety and well being of adopted horse and the transportation off the
ranch to new home. Any accidents that may occur after the horse and has left the property on Golden Hills Drive it
becomes the sole responsibility of new owner and no refund is awarded, nor damages to trailer or person
transporting.
________________________________________________ ___________________
Signature of Adopter (s) Date
________________________________________________________________________
Printed Name of Adopter (s)
________________________________________________ ___________________
Signature of Representative of GHRER&R Date
________________________________________________________________________
Printed Name of Representative and Title