Oatman Burros Sanctuary
EQUINE SURRENDER AGREEMENT
I, the undersigned, irrevocably surrender and relinquish to Oatman Burros Sanctuary for placement, adoption, or retirement, the following equine(s):
Breed: _______________________Registration No. ___________________ (attach registration papers if applicable)
Age: _________ Sex: ______________
Reason(s) for surrendering the above equine(s):
If the above equine(s) is/are mare(s), is there a possibility she could be pregnant? Y__ N___
Identification (tattoos or brand(s): ____________________________________
Color and Markings: ______________________________________________
Ridable: Y__ N__ Discipline (English, Western): _________________________
Has/Have this/these equine(s) ever received professional training? ______________
What type of training and for how long? ________________________________
Has this equine ever injured anyone? Y____ N___
If yes, please explain: ____________________________________________________________
Any habits we should know about? (biting, kicking, cribs, etc?) ____________________________________________________________ ____________________________________________________________
Phone number of any Veterinarian who has treated animal and state: ____________ ____________________________________________________________
Phone number for any farrier who has treated animal and state:________________ ____________________________________________________________ Please list dates of equine’s last vaccinations, worming, hoof and dental care:
Rhino Flu Rabies
West Nile Virus Worming
Hoof Care Dental Care
Date:___________________________ Date: __________________________ Date: __________________________ Date:__________________________ Date:__________________________ Date:__________________________ Date:__________________________
Attach most recent vet/dental records to this form. If the horse has not been vaccinated in the current calendar year, please vaccinate the horse before surrendering and provide copies to records to Oatman Burros Sanctuary. If you need financial assistance with this, please let us know immediately.
Does this horse have a current coggins? Y__ N__
(Please attach current coggins per Arizona State Law Regulations.)
Are there any medical conditions that we should be aware of? (ie. Founder, choke, allergies, vaccine reactions, history of colic, cushings, EPM?) ____________________________________________________________ ____________________________________________________________ _____________________________________.
Is this equine accustomed to pasture turn out? Y___ N___ Stall? Y____ N_____
How does this equine get along with others in a herd situation? (ie. Alpha, okay with everybody, fights) _______________________________________________ ____________________________________________________________ ___________________________________.
Does this equine stand easily for farrier? Y___N___ If no, please list anything that makes trimming easier (ie, sedations, etc) _______________________________ ____________________________________________________________
Does this equine load easily? Y__ N___. Explain.__________________________ ____________________________________________________________ ____________________________________________________________
Representations and Warranties
I hereby represent and warrant to Oatman Burros Sanctuary that the undersigned is the sole owner of the above described equine; has the authority to surrender this equine for adoption/placement or retirement from Oatman Burros Sanctuary; that no other person or person’s signature is required to initiate a valid transfer of ownership and registration papers on this equine (if available); and that no others person or persons has any legal equitable ownership interest in this equine.
Delivery of Registration
I agree to deliver to Oatman Burros Sanctuary, a properly signed transfer of all registration papers, if available, for the above described equine(s), omitting the name of the transferee.
Other Pertinent Information and Consent for Contact
I also agree to provide Oatman Burros Sanctuary, with all available information concerning this equine which might assist with finding the equine a future home. This information includes but is not limited to health/vaccination records, previous owners’ identification, life events, and individual personality traits. I also understand Oatman Burros Sanctuary. may contact previous owners, breeders, veterinarians, and farriers to obtain information and assist in leaning and making transition more comfortable and/or find the best suitable home for placement.
By executing this document I understand that I am giving up forever rights to, titles to, and interests, regardless of the delivery or non-delivery of registration papers to the above equine(s) voluntarily and without coercion or threats of any kind. I further understand that all future decisions regarding the placement of this equine will solely be those of Oatman Burros Sanctuary. I also understand if this equine is found to be unsuitable for placement for reasons determined by Oatman Burros Sanctuary and/or a licensed veterinarian that the equine may be retired at Oatman Burros Sanctuary to its sanctuary program or euthanized. Lastly, it is understood that the surrendering party shall hold Oatman Burros Sanctuary, and all its officers, directors, employees, and volunteers harmless from any claims of damages, injury, or acts of negligence arising from this surrender.
This is a legally binding document for the irrevocable surrender of an equine for placement in an adoptive home by Oatman Burros Sanctuary. Please read this document carefully and thoroughly before signing. Take as much time as you need to consider this decision.
PRINTED NAME: _______________________________________________
TELEPHONE NUMBER: __________________________________________