Adopter's Name:_____________________________________ Address:_______________________________ City:_________________________ State:________ Zip:____________ Phone:_________________________ Email:_____________________________ ID:______________________________
It is accepted that on this _______ day of ___________________________ the above named person(s) adopt from ____________________________________ a canine described as follows:
Name:_____________________ Sex:_______________ Color:______________________
Age or DOB:__________________ Tattoo:_________________
The dog is spayed or neutered and has current vaccinations.
I/We hereby agree to care for this dog humanely (including providing adequate food, water, shelter, love and attention). Said dog shall be maintained in an adequate enclosed area or on leash at all times. Dog shall not be allowed to roam at will. I/We agree to have dog vaccinated annually with necessary innoculations (DHLP-P) and vaccinated against Rabies, as local ordinances require. I/We agree to provide essential veterinary care, as needed. If said dog becomes lost or stolen, I/We agree to notify ________________________ immediately.
I/We also agree not to sell, trade or dispose of this dog. If, at any time, I/We are unable or unwilling to care for this dog, I/We agree to contact and return said dog to ____________________________. The adoption fee will not be refunded after 10 days from adoption date. I/We also agree that _______________________________ will keep ______ of the adoption fee, if dog is returned within the 10 day period. I/We further agree that said dog shall not be used for medical or any other experimental purposes or sold or given to a pet store, supplier or wholesaler.
agree that said dog will not be used for any illegal purposes and will
NEVER be fought in any way.
I/We certify that we do not live in an area where "Pit Bulls" are banned.
I/We agree to notify _______________________________ within 10 days of any change of address or phone # (and vice versa). It is also understood that ________________________________ may examine and make inquiries about said dog at any time. If not satisfied with the condition of the dog or the conditions in which it is kept, said dog can or may be removed immediately and placed in a different home. Any veterinary services needed due to negligence or lack of care, will be the adopters responsibility and payable to ________________________________
I/We understand that ______________________________makes no guarantees or warranties regarding the health or temperament of this dog. I/We promise and agree to be solely responsible for this animal, and to indemnify and hold harmless ______________________________ from any and all claims of liability for the conduct of this animal on or after the date of this adoption. This Release of Liability and Indemnification shall apply to all known, unknown and unanticipated damages resulting from my/our adoption, ownership or control of such animal.
I/WE HEREBY ACKNOWLEDGE THAT I/WE HAVE READ AND UNDERSTAND THE ABOVE TERMS AND CONDITIONS AND WILL KEEP THE DOG DESCRIBED HEREIN AS A FAMILY MEMBER. I/WE UNDERSTAND THAT THIS IS A BINDING CONTRACT ENFORCEABLE BY CIVIL LAW.