TRIAL HORSE APPLICATION

Name of Owner:

First

Last

Phone

Email

Address

Address Line 1

City

State / Province / Region

Postal Code

Country

Name of horse/pony:

Registered Name (if applicable)

Age/DOB:

Sex

Breed

Height

hands

Build

light/average/heavy

How did you hear about the trial horse/free lease program?

If, after evaluation, the horse is determined to be a candidate for trial are you willing to allow the horse to come to CKRH for a 90-day trial period?

Yes
No

How long have you owned this horse and how did you acquire him/her?

General Care & Health

Does this horse have any medical conditions or on any special medications/supplements?

Yes
No

Has this horse ever foundered?

Yes
No

Has this horse ever shown signs of colic?

Yes
No

What kind?

Is this horse walk/trot/canter sound or does he/she have any limitations?

Yes
No

What kind?

Does this horse have any history of lameness, injury, arthritis, or surgeries? Joints injected?

Yes
No

Describe

What type of boarding is the horse currently in – stalled 24/7, pasture only, etc.?

What are this horse’s feed requirements? What type and how much daily? Any hay restrictions?

What types of fencing has this horse been kept in?

(ie. 3-plank wood, electric tape, steel pipe)

How is this horse to catch in the fields?

Does this horse need shoes?

Yes
No

What type of shoes?

When was this horse last dewormed? What product was used?

When was this horse last vaccinated? Which vaccinations were received?

When did this horse last see the farrier?

Has this horse had a Coggins test?

Yes
No

Date

Disposition, Training & Experience

What is this horse’s attitude towards his owner? Strangers?

What rank is this horse with other horses?

Dominant
Middle
Low

Does this horse bite people or other horses?

Does this horse have any vices or bad habits (ie. Cribbing*, wind sucking, nibbling, etc)?

*CKRH has a no cribbing policy - if a horse has a history of cribbing or is seen cribbing at any time, CKRH reserves the right to send the horse immediately back home.*

Does this horse kick when another horse approaches from behind?

Yes
No

Is this horse herd bound/have problems with separation anxiety?

Yes
No

Does this horse mind being in a stall?

Yes
No

Does this horse tie, cross tie, and/or ground tie?

Yes
No

How are this horses ground manners when leading, picking feet, brushing, saddling, bridling?

(Leading: Too quick/too slow; Pick up all 4 hooves? Pushy? Mouthy/Nippy? Girthy?)

What type of riding and other activities have you done with this horse?

What type of equipment is normally used with this horse?

(Type of bit, saddle pads, etc.)

What other tack and equipment have been used on this horse that is not part of the regular routine?

(neck rope, long lines, lunge whip, other bits & saddles, etc.)

What did this horse do before you owned him?

When was the last time this horse was ridden and how often are they worked?

What level rider can handle this horse on the ground and under saddle? Is this horse able to be ridden by a rider ages 4-90? Explain.

Does this horse have any professional training?

Does this horse trailer?

Yes
No

Has your horse done any of the following?

Which of the following riding maneuvers is your horse familiar with

Trial Information

According to CKRH policy, the owner (or someone acting on the owner’s behalf) must ride the horse in front of CKRH evaluators before the evaluators may ride. Please understand that we may not give your horse a fair evaluation if we must also supervise small children. Please make arrangements for children prior to your horse’s evaluation. By typing your full name below, you acknowledge that you have read and understood these terms.

Signature

Clear Signature

If we decide to bring your horse in for a 90-day trial, we request that owners provide their own transportation for that horse to our facility. If this is not possible, please notify the Equine Manager to investigate other options. By typing your full name below, you acknowledge that you have read and understood these terms.

Signature

Clear Signature

Horses leased to the program can be ridden by CKRH staff and participants only. Horse owners and volunteers are not permitted to ride during the leasing period due to the equine usage and training protocols of the organization. By typing your full name below, you acknowledge that you have read and understood these terms.

Signature

Clear Signature

Horse owners may visit their horses at any time so long as the Equine Manager is notified to ensure the visit will not impact a participant’s riding lesson. Upon the first visit, owners are required to sign a visitor liability agreement before interacting with horses or participants. By typing your full name below, you acknowledge that you have read and understood these terms.

Signature

Clear Signature

If we decide to evaluate your horse, is there an open field, pasture, ring/indoor arena, or another area where we may ride? If so, is this space indoor or outdoor?

Owner’s Availability for Initial Visit: Please list days and times that you are available.

Location of Horse/Pony & Directions (please include road conditions)