Click Here Adoption Application in .pdf format
You may choose to submit our Online Application (there is a link to it on our Home Page), or feel free to print a copy of the Application (shown below and also in .pdf format above), fill it in, and return it to us by email to sallymcaninch@gmail.com
ADOPTION APPLICATION/CONTRACT
Our goal is to place pets in permanent, loving homes. Please complete this application and contract so we can assist you in finding a special, compatible companion to join your family. With this information, we minimize the risk of a failed adoption. We do not adopt dogs or cats on a “first come, first served” basis, but rather make every attempt to match families with the most compatible pets. We reserve the right to decline any application. The adoption fee for dogs varies, depending on the costs incurred by the Rescue for veterinary care & examinations, including spaying/neutering, vaccinations, worming, testing, heartworm treatment for heartworm positive dogs, flea/tick & heartworm preventative, transport, and other incidental expenses.
Please print clearly. (Must be at least 21 years of age to adopt)
NAME:
Name of animal in which you are interested: Date:
Breed/Description: Male/Female
Release for Veterinary Reference: (to be completed by potential adopter)
I, , hereby give permission for any veterinarian providing service to me to release medical information on any/all of my animals.
(signature)
My current veterinarian is
located at and can be reached at ( )
Date of Birth: Email Address:
Address (include City and Zip Code)
Home phone ( ) Cell phone ( )
Employer & Occupation What are your hours?
Spouse/Partner Employer & Occupation
How long would the pet be left alone? Where would the pet stay?
What will you do with this pet if you have to move?
Are you willing/able to purchase and use a crate if needed or advised?
Do you have a pet door? How would you handle the dog’s potty needs?
Have you housetrained an animal before? If so, describe how you accomplished this
How would you exercise the pet?
Do you live alone or with family? Does every adult in the household agree on owning this pet?
Does anyone in the household have allergies? If so, are they allergic to animal dander?
Do you have children/grandchildren? What ages?
Do they live in the household? If they do not live with you, how often do they visit?
Are you willing and able to commit to behavior and/or dog obedience training?
Do you own or rent? House or apartment? If renting, how long at this location?
If renting, does your lease allow pets? Breed or weight restrictions?
Pet deposit? (We will need confirmation of payment of any required pet deposit.)
Rental manager’s name and phone number
Do you have a fenced yard? What type of fence and how high?
Have you ever given up animal(s)? If so, why?
What did you do with the animal(s)?
What qualities are you looking for in a pet? (Please be specific)
What traits or characteristics are you sure you do NOT want?
PET OWNERSHIP HISTORY
Name Dog or cat? How acquired?
Breed Spayed/neutered?
Age of pet Length of ownership
What happened to this pet?
Name Dog or cat? How acquired?
Breed Spayed/neutered?
Age of pet Length of ownership
What happened to this pet?
Name Dog or cat? How acquired?
Breed Spayed/neutered?
Age of pet Length of ownership
What happened to this pet?
1. I agree my adoption fee is NON-REFUNDABLE even if the pet is returned to the Rescue Group.
2. I agree that I will never sell, trade, or give away this pet to anyone. I will never relinquish this pet to any shelter or pound, whether “no-kill” or otherwise. I will notify _________________________ if I am unable or unwilling to keep this pet, and I will return this pet after arrangements have been made for such return. I agree to assist with the return if necessary. I will keep tags on the dog with current information at all times.
____ 3. I agree that all future medical and health maintenance treatments are my responsibility, unless has specifically agreed to pay for them under the “special provisions” at the end of this contract. I will administer monthly heartworm preventative to the dog year round.
4. My dog will be primarily indoors, interacting with my family, and will not to be banished to the back yard. I will never tie my dog to a chain or rope or leave him/her unattended for long periods.
5. I will protect this pet with annual vaccinations and routine medical care and health maintenance as recommended by my veterinarian. I will seek immediate (at time of injury or signs of illness) veterinary care if this pet becomes ill or is injured. I understand this is for the lifetime of the pet.
6. I agree that the pet SHALL NOT be physically altered in any manner (docking tails, cropping ears, declawing, etc.).
7. I will comply with all state and local ordinances in the confinement, care, and licensing of this pet. I will reclaim this pet promptly, and pay any required fees if it is picked up by an animal control agency. Rabies and ID tags will be kept on the animal at all times.
8. I understand that there are no guarantees regarding the age, nature, temperament, or health of this pet. I assume all risk and responsibility of ownership of this pet once he/she is in my possession. I agree to defend, indemnify, and hold harmless____________________________ and its agents against any and all claims including claims of property damage and/or personal injury, which arise from my adoption of this pet.
9. If I fail to fully and timely comply with the terms of this contract, I will, voluntarily, immediately release ownership, possession, custody and control of this pet to ______________________________, and if I fail to do so,_______________________ will be entitled to enforce specific performance of this contract in addition to any other legal remedy available.
10. I affirm that all information in the Application is true, complete and correct and agree that any false or misleading statement thereon will constitute a breach of this contract.
11. Special provisions of this contract, if any, are as follows: