Jumping H Farm Re3 Adoption and Therapy
689 Joe Layne Mill Rd.
Elkin, NC 28621
www.RE3OTTB.com
Jumping H Farm Re3 Adoption and Therapy Application
Please return to the address or email above.
Name:_________________________________________________________________________________
Address: _______________________________________________________________________________
City: _________________________________________________ State: _______ Zip ________________
Phone: (Work) ____________________ (Home) ____________________ (Cell): ___________________
Email: _________________________________________________________ SS#:___________________
Age: _____________ Employer: ___________________________________________________________
Specific horse from our web page: __________________________________________________________
What qualities do you prefer: ______________________________________________________________
Gender: _________________ Height: (hands) __________ Age: _______
Have you worked with Thoroughbreds off the track before? (Explain): _____________________________
______________________________________________________________________________________
______________________________________________________________________________________
How long have you been riding? ____________________________________________________________
Discipline: (Ex: jumpers, trail, dressage, eventing, western, etc.) __________________________________
Do you consider yourself a beginner, intermediate or advanced rider? ______________________________
Have you ever owned your own horse, and for how long? ________________________________________
Are you aware that a horse requires regular attention, and can cost approximately $4,000 to $8,000/year to
board, shoe, feed and provide veterinary care?
Have you ever sold a horse through an auction? If yes, explain: ___________________________________
______________________________________________________________________________________
Jumping H Farm Re3 Adoption and Therapy
689 Joe Layne Mill Rd.
Elkin, NC 28621
www.RE3OTTB.com
Jumping H Farm Re3 Adoption and Therapy Application
Will you be working with a trainer? (Please give his/her name, if applicable): ________________________
______________________________________________________________________________________
Intended Use for Horse: __________________________________________________________________
Where will horse be stabled? (Address): ______________________________________________________
______________________________________________________________________________________
If horse is to be boarded, please supply owner/farm manager’s name and contact number: ______________
______________________________________________________________________________________
Acreage of farm: ________________________ Number of horses on property: ______________________
Type of shelter available for horse: (ie. 10 x 12 stall, field, run-in shed): ____________________________
______________________________________________________________________________________
Type of fencing: ________________________________________________________________________
Plans for transitioning your horse to his/her new home, including pasture mates, schedule, training, etc.:
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
REFERENCES:
VETERINARIAN:
NEIGHBOR:
Name: ____________________________________ Name: ____________________________________
Phone: ____________________________________ Phone: ____________________________________
CHARACTER REFERENCE (someone who knows your ability/experience with horses; i.e. barn manager,
trainer, riding partner, etc.):
Name: ____________________________________
Phone: ____________________________________