A Request for Assistance/Agreement A Request for Assistance/Agreement Date *mm/dd/yyyy First Name, Last Name * Email * Phone * Address: * How many horses are needing assistance at this time? The reason for contacting HAPI Trails or HAPI Trails contacting you: * Horse(s) is not at a healthy weight Owner is financially* unable to care for horse(s) Horse(s) is sick Owner is physically unable to care for horse(s) Horse(s) is injured Law Enforcement has been called Owner is seeking "Safe Haven" for horse(s) Emergency Short-Term Assistance Vet Relief Program Request Resource Request Hay/Feed Financial Assistance Other (indicate below) Horse has been Abandoned Please provide more information on why HAPI Trails is needed: * Horse #1 Horse Name (1): * Gender * Gelding Mare Stallion Age: * Breed: * Color: Horse #2 Horse Name (1): Gender Gelding Mare Stallion Age: Breed: Color: Horse #3 Horse Name (1): Gender Gelding Mare Stallion Age: Breed: Color: Horse #4 Horse Name (1): Gender Gelding Mare Stallion Markings Age: Breed: Color: I hereby acknowledge and agree to the following: * HAPI Trails has only been contacted to determine the proper requirements and care for assisting in the rehabilitation of the above named horse(s). At no time can I hold HAPI Trails liable for any outcome of their recommendations and/or assistance, which also may include the death of the above mentioned horse(s). *Unless otherwise determined and a set amount is agreed upon, I am responsible for all costs including, but not limited to, all feed purchases, medical supplies, vet/dental/farrier visits associated with HAPI Trails recommendations. *Unless otherwise determined and a set amount is agreed upon, any money expended by HAPI Trails at my request and on my behalf, the amount will be repaid within 30 days. HAPI Trails has my full permission to perform a site visit to evaluate my horse(s), which includes access at any time where they are being kept. (Arrangements will be made if the horse(s) are being boarded) until termination of this agreement by both parties within 4 weeks. This case is public record and all information and photos can be used at any time by HAPI Trails to promote Equine Education at HAPI Trails’ discretion. Respect for the owner is ALWAYS considered. These records may be turned over to local Law Enforcement officers, should the records be requested, or if HAPI Trails determines that I, as the owner, am not fulfilling my part of this agreement or following their recommendation to the best of my ability. I accept full responsibility for the horse(s) actions at all times, and release HAPI Trails from any liabilities or damages that may be incurred because of adoptin such horse(s). Additional Assistance Requested Farrier Vaccinations Coggins Gelding Hay Special Feed Veterniarian Help Massage or Body Work Other Request IMPORTANT!! Please Note: Indicate which Agreement you are requesting from HAPI Trails This Agreement is for 3 months (90 days). If the situation/need has not been resolved and the horses are still in HAPI Trails' care at the end of the 3rd month, HAPI Trails will assume ownership of the horses and place them into our Adoption Program. YOU MUST ACKNOWLEDGE the three month resolution if horses is in HAPI Trails care. Short-Term Assistance only This Agreement is short-term Owner Assistance. This Agreement is for financial or off-site Assistance. Signature Clear Captcha If you are human, leave this field blank. Δ
