SUBMIT A CHILD FORM
Please Print out Form & Submit to T & C Foundation by US MAIL
send to:
T & C Foundation
1670 2200 East Street
Battle Mountain , Nevada
89820
Please Note....... We will not be taking any new Child or Horse Submit Forms until Late October 2006
You may Submit you Child via email by coyping & pasting form to a email. PLEASE NOTE: We can not work on Your Child's Dream until we have received your Submit A Child Form Signed & received thru the US Mail.
NAME & AGE OF CHILD ___________________________________________
NAME OF PARENT
NAME OF PARENT
OR LEGAL GUARDIAN _____________________________________________
ADDRESS ________________________________________________________
PHONE NO __________________________________________
DESCRIBE FACILITIES IN WHICH HORSE
WILL BE KEPT_____________________________________________________
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DESCRIBE YOU & YOUR CHILD’S
EXPERIENCE WITH HORSES________________________________________
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DESCRIBE YOUR INTENDED USE
FOR THIS HORSE IF APPROVED_____________________________________
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PLEASE TELL US WHAT YOUR CHILD’S IDEA
OF THEIR DREAM HORSE IS ________________________________________
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WOULD YOU ACCEPT A HORSE THAT WAS BLIND. ______________
WOULD YOU ACCEPT A HORSE THAT HAD SPECIAL
NEEDS, FEEDING, MEDICINES ETC...
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PLEASE TELL US THE PREFERRED AGE YOU WOULD
LIKE THE HORSE TO BE AND ALSO THE AGE
LIMIT OF A HORSE YOU WOULD BE WILLING TO ACCEPT._______________
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WOULD YOU ACCEPT A HORSE OTHER THAN WHAT
YOUR CHILDS DREAM HORSE DESCRIPTION WOULD BE _________________________________________________________________
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WHY YOU WOULD LIKE TO RECEIVE A HORSE FROM THE TERA & COCO HORSES & DREAMS FOUNDATION _________________________________________________________________
_________________________________________________________________ _________________________________________________________________ PLEASE TELL US YOUR CHILD'S STORY IN DETAIL ,  ) _________________________________________________________________________________
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PLEASE LIST 3 REFERENCES. THEIR NAMES, PHONE NUMBERS,
LOCATION AND OCCUPATION. NO FAMILY REFERENCES!
THANK YOU!
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YOUR VET'S NAME , ADDRESS & PHONE NUMBER
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YOUR HORSE SHOER'S NAME & PHONE NUMBER
_________________________________________________________________________
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YOUR HORSE SHOER'S NAME & PHONE NUMBER
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CONTRACT / AGREEMENT FOR T & C FOUNDATION HORSE
CONTRACT / AGREEMENT FOR RECIPIENT recipient's
Name(Legal Guardian)____________________________________________
Address_____________________________________________________
Phone No.____________________________________
1. Please remember that complete honesty is the best policy.
The Tera and Coco Horses and Dreams Foundation (hereafter referred to as The Foundation)
wants our donor horses to go to legitimate children who need them.
All questions on the initial application must be answered
truthfully..
2. Should The Foundation discover any false statements made on the initial application, no horse
will be given to applicant. If a horse has already been delivered to applicant,
said horse will be repossessed immediately and without further question.
3. The Foundation horses are for CHILDREN. You must have a child who is in need of a riding
horse to qualify. Horses are not given for parents or other relatives or friends to use for their own
personal horses.
4. You must have a general knowledge of how to keep and care for a horse or someone close
by to help out. You must also have proper facilities in which to keep said horse.
5. Should the time come when you no longer wish to keep the horse you received or
can no longer care for the horse, said horse MUST be returned to the Foundation in healthy
and sound condition or in the same condition in which you received the horse, to exclude
natural aging or accidental damages.
6. Although horses given have been checked by a qualified veterinarian, The Foundation
makes no guarantees regarding the horse's future health or soundness. Any health or
soundness issues discovered before delivery of said horse will be disclosed to recipient.
7. Although our goal is to provide safe well-broke horses to children, and each horse is
investigated to the best of our ability, The Foundation makes no guarantees regarding the
horse's future actions. The Foundation assumes no liability or responsibility for any horse
once the recipient takes possession of the horse.
8. Recipient must be able to take possession of the horse within six (6) months of the signing
of this agreement.
9. By signing this contract you are agreeing that you will not abuse or neglect said horse in
any way and will provide all basic needs for the horse including vaccinations, de-worming,
regular farrier work, and any special feed required for an individual horse. The foundation has
the right to remove & WILL remove said horse from recipients care under unacceptable circumstances
which include,not being cared for, thin, no food, water, abuse, no attending vet when horse is
sick or Injured , hoof neglect. Should you ACCEPT A HORSE WITH SPECIAL NEEDS, HEALTH ,
HOOF CARE , FEEDING, MEDICAL ISSUES ETC.. AND DO NOT CARE FOR SAID HORSE'S SPECIAL
NEEDS , THIS IS UNACCEPTABLE CARE AND NEGLECT & ABUSE OF SAID HORSE ,
THE FOUNDATION WILL REMOVE SAID HORSE WITHOUT NOTICE . There will also be a 3 month,
6 month, and 12 month check on so said horse.. If so said horse is removed from recipients
home, due to unacceptable circumstances said horse will be placed with a foundation officer
or a Foundation appointed Foster Home .
10. You must provide us with at least three (3) reliable references along with occupation,
addresses and phone numbers. Do not include relatives.
11. The Foundation will do its best to try to match your child with a horse that is suitable
for him/her. Please do not make requests for a certain color, breed, size, etc.
We try to match children to horses we have already available or as they become available.
12. Should you receive a horse from the Foundation and find at a later date that the horse
is truly not a match for your child, please contact the Foundation. We will investigate the
matter and try to locate a horse better suited for your child. This should only be done in
extreme cases.
13. Should you accept a horse from The Foundation you agree to allow the
Foundation to publish your story and photos on The Foundations web site and also
agree to allow the foundation to use your story for media.
14. Should you accept a horse from the foundation you fully understand that there will
be no set time-line on delivery of so said horse. You are also fully aware that the
ability of the foundation to find so said horse for recipient is not guaranteed.
After so said horse is delivered to recipient, information on the donor of the horse will
then and ONLY THEN be given to the receiving party unless the donor requests that
information not be given.
15 .Should you accept a horse from the foundation, this horse cannot be relocated
with out notifying the foundation first. The foundation will need to have all
new contact information at so said horses new location.
16. Should you accept a horse from the foundation, the foundation has the right
to check on the so said horses welfare at any given time. The foundation will
provide a 24 to 48 advance notice if requesting an on premises check.
If the foundation finds the welfare of the horse to be unacceptable the
foundation can and will remove so said horse. (Unacceptable Care of said horse :
meaning, thin, no food, no water, abuse, injured or sick, and NO attending Vet , hoof neglect).
There will be a Placement Check , 3 month, 6 month, and 12 month check on so said horse..
17. Recipients of said horse are fully aware Tera & Coco Horses & Dreams Foundation areThe
Legal owner of said horse ( Grade or Registed ) Recipients fully understand they may keep and care
for said horse natural life as long as said horses is cared for & keeped in good health free of abuse or
unacceptable care If any registered horse is given to said recipient the so said horses original registration
papers will be kept with the foundation and will be transferred into the foundations name. Recipient will
receive a copy of these papers. If recipient would like to show so said registered horse the
foundation will contact and get approval from the appropriate association
for the recipient to be allowed to show. Recipient will be allowed to show
amateur, youth, novice.
18. On breeding a foundation horse......
WE ARE NOT PLACING THESE MARES TO BE BROODMARES.......
But if an older mare is placed with a recipient and this is their Dream Horse......
If the Family would like to breed said mare before she is too old to foal, then the
recipient/legal guardian must contact the foundation.
A new contract for the upcoming foal is to be signed with the foundation.
The Foundation has several Stallions, all different breeds that our members
would be happy to donate the Stallion service for just such a foal.
19. Whichever officer contacts you regarding your child/horse submit form,
this is the officer you will work with for the entire process of the foundation.
20. All business including but not limited to, delivery or pick up of horse will be
dealt with privately between the officer assigned and recipient/donor.
21. If you have a grievance with the foundation or any of its officers please
contact The Foundations Secretary Phyllis Stuart. DO NOT POST ON
GROUP MESSAGE BOARD. We have many Children that read T & C Foundation
Group Message Board , Keep Any & All disagreements OFF the board .
22. Parents / Legal Guardian of Recipient of said horse understand the inherent dangers
risks of equine activities. Therefore, in the event of any injury, death or property loss caused
directly or indirectly by said horse placed , I / We release from liability Tera & Coco Horses
& Dreams Foundation ( T & C Foundation) , All Board Members & Board Members Family's
23. By signing this form it verifies that you have read and are aware of the
above rules, regulations and practices of the foundation. Should you sign this
form and do not comply with all of the above, you are
agreeing to allow the foundation to terminate this contract and to terminate
any and/or all dealings with so said recipient/donor at the foundations discretion.
23. NO ACTION WILL BE TAKEN ON THIS APPLICATION UNTIL
ALL FORMS HAVE BEEN COMPLETELY FILLED OUT, SIGNED &
RECEIVED VIA US MAIL.......
I have read and understand the provisions in this agreement.
Recipient Signature _____________________________________Date______________
Tera and Coco Horses and Dreams Foundation Member Signature
____________________________________________________Date_____________