Central Virginia Horse Rescue
389 Boydton Plank Road
Brodnax, VA 23920
434-447-4948
www.centralvahorserescue.com
Horse:______Date:___/___/___
Central Virginia Horse Rescue Application /Contract
INSTRUCTIONS FOR COMPLETING THIS APPLICATION
Please read and complete this entire document carefully and mail it, to the address listed above. This application must be completed in full. Application can be emailed to
APPLICATION PROCESSING
All information and references submitted on this application will be reviewed by our staff and in signing it you are agreeing to the terms within.
This application is not to keep you from adopting the horse but to insure the safety of each horse. These horses have been at risk and it is CVHR’s mission to see that they are provided with a safe and loving home.
YOUR INFORMATION:
Name First and Last:
Email address:
Telephone #:
Cell Phone #:
Address:
Employed by:
Title:
Address: ______Telephone: ______
Please circle. I currently own a: horse / burro.
I have / have not owned a horse / burro.
The type of corral or stall which will be provided is:
______(size______)
The horse will be kept at this address: Boarding or Residence? (Circle one please)
______
Telephone: ______Business hours:______
The daily feeding will be done by ______.
The boarding facility is ______miles from my residence.
What do you intend to use this horse for?______
DESCRIPTION OF HORSE TO BE PURCHASED:
Be sure to list the horse’s name or number and description here.
Name:______Gender:______Age:_____ Height:______Breed:______
Color:______Markings/Brands (identifiablemarks):______
Any Special Needs:______
______
Adoption Fee of $______
Other:______
REFERENCES:
1. Name:______Telephone: (____)______-______
2. Name:______Telephone: (____)______-______
3. Name:______Telephone: (____)______-______
4. Farrier:______Telephone: (____)______-______
The equine veterinarian who will care for this animal is:
Name:______
Address:______Telephone: (____)______-______
Waiver of Liability
By signing below, the buyer understands that Central Virginia Horse Rescue (CVHR) makes no representations or warranties concerning any horse offered for adoption through the programs, including but not limited to the condition, health, temperament, soundness, or fitness for particular purpose. Buyer understands and agrees that Central Virginia Horse Rescue, Inc, its officers, directors, representatives, volunteers, agents, servants, and assigns, are not liable for any representations or misrepresentations concerning any horse offered for adoption through this program; all information listed on the website via www.centralvahorserescue.com, and/or divisions thereof, regarding any particular horse is based solely on information provided by the owners or authorized caretakers.
I, (adopter), do hereby release CVHR, its officers, directors, representatives, volunteers, agents, servants, and assigns (collectively “Releasees”) of and from any liability arising from representations, misrepresentations, care and handling of the horses offered for sale either via http://www.centralvahorserescue.com.com or any divisions thereof. I further agree that Releasees are not liable for the mistakes and/or negligence and/or intentional acts of service providers and/or contractors such as livestock haulers, veterinarians, or handlers who may at any time be in the care, custody and control of the horse I am adopting. I understand that I may pursue claims against such third parties for any damages caused by mistakes, negligence and/or intentional acts of such third parties during the time that my horse is in their care, custody and control.
Agreement
Signing this application authorizes CVHR to contact the above listed references and inquire about your equine experience. You agree to send CVHR updates at 3 months, 6 months and 1 year after acquisition of the animal.
It is agreed that if said animal is offered for sale, in the future, that CVHR will be notified and given First Right Of Refusal. CVHR has seven (7) days in which to exercise its First Right of Refusal from the date of notification by the owner. If CVHR opts not to exercise its First Right of Refusal, the owner shall provide CVHR with the name, address and telephone number of any prospective owner to which the horse may be transferred so that CVHR may update its records and monitor the whereabouts, health and safety of the horse. It is further agreed that any subsequent owner will complete a copy of the within Application and Agreement, and the subsequent owner shall be bound be the terms thereof.
Finally, the undersigned agrees that this animal will only be transferred privately and will not be resold at any type of auction, horse broker, feed lot or slaughter destination and that the animal will be transferred under contract with this paragraph included in the contract.
In the event the undersigned fails to comply with the terms of this Application and Agreement, CVHR reserves the right to commence legal proceedings to recover the horse, and the undersigned shall be liable for all costs including damages to CVHR, is assumed at a minimum of $5,000.00, inclusive of attorney’s fees, in connection with such legal proceeding.
This offer is accepted by:
Signed Date
*Buyer signature warrants that they buyer is at least 18 years of age at the time of signature and acknowledges receipt of the Processing Terms and Conditions contained within this agreement.
Office Use Only
Approved: Date: