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Name:_______________________________________ Phone: Home(____)______________

Address:_____________________________________ Phone: Work(____)______________

City/State/Zip:_________________________________

Do you currently own a horse? YES____ NO_____ If So, How Many?_________

Are your horses boarded? YES_____ NO_____ Do they Live at home? YES_____ NO_____

If yes, please add the name, address and telephone of boarding facility.____________________

________________________________________________________________________

Please describe the facilities for your adopted horse:_________________________________

________________________________________________________________________

This is a horse rescue – so please keep this in mind when you receive your horse. The United Pegasus Foundation would like to emphasize, WE ARE ACTING AS AN AGENT ONLY and are to be held harmless of any disagreements between the adopter and the ranch the horse originated from. The Adopter needs to accept that this is an ‘as is’ situation as we are trying to help rescue the horses from an uncertain future but the UPF does not know these horses. Please state the number, ranch of origination and name of the horse you are interested in:

Horse #:____________________

Ranch #:____________________

Name:________________________

Breed:_____________________

Sex:_______________________

Color:______________________

What so you plan to do with this horse?
________________________________________________________________________________ ________________________________________________________________________________
________________________________________________________________________________
How much experience do you have with horse?
________________________________________________________________________________ ________________________________________________________________________________
________________________________________________________________________________

Please provide the name, address and telephone number of your veterinarian: ________________________________________________________________________________

May we use your veterinarian as a personal reference? YES_____ NO_____

"It is understood that I will provide proper stabling, veterinary care and farrier attention as needed for good health and preventative care."

AGREED:

Signature:_____________________________________ Date:_____________________

Please return this application with the adoption fee in United States funds to: The United Pegasus Foundation, 120 S. First Avenue, Arcadia, California 91006.

RELEASE OF LIABILITY (Please read carefully and return with application)

Adoptee shall assume all responsibility, risk, and liability for the care and control of the horse adopted in their behalf by the United Pegasus Foundation from the date of adoption forward. It is understood that the adoptee shall hold the United Pegasus Foundation and all it's officers, directors, and volunteers harmless from any claims of damage, injury, or acts of negligence, howsoever caused, to adoptee or any other party. United Pegasus Foundation can make no claim nor warranty for horses before or beyond their date of adoption as this is a rescue and the United Pegasus Foundation is acting as an AGENT only.

Adoptee agrees that neither he/she not any assignees, heirs, distributes, guardians or legal representatives will make any claim against, sue, nor attach the property of the United Pegasus Foundation, it's officers, directors, or volunteers, for any actions or claims whatsoever arising from this adoption agreement.

I HAVE READ AND THOROUGHLY UNDERSTAND THIS RELEASE OF LIABILITY AND AGREE TO ABIDE BY IT.


AGREED:

Signed:___________________________________________ Date:____________________


______________________________________________________________________________

Please return this application to:

The United Pegasus Foundation, 120 S. First Avenue, Arcadia, CA 91006.