Sample Adoption Agreement
NAME OF DOG:____________ BREED:____________ COLOR:____________
AGE:____________ SEX:____________ SPAYED/NEUTERED:____________
DISTEMPER/PARVO (DHLPP):____________ BORDETELLA:____________ RABIES:____________
BOOSTER DUE, DHLPP:____________ BORDETELLA:____________ RABIES:____________
PLEASE READ AND INITIAL THE FOLLOWING BEFORE SIGNING:
- Rover Rescue requires a dog adoption fee of $200.00 to help defray the expenses for food, boarding, medical care and advertising. Rover Rescue has a very limited budget. The adoption fee is not refundable under any circumstances. Any donation made in addition to the adoption fee would be greatly appreciated.
- I Agree that this dog is being adopted as a FAMILY PET and will be given extensive house privileges, i.e., sleep inside the house, be allowed freedom of the house when the family is home and will NOT be primarily restricted to the yard.
- I understand that this dog was previously unwanted or lost and may have been rescued by Rover Rescue from a dangerous, unhealthy and/or cruel situation. This could have long-lasting effects on the dog. You agree that Rover Rescue is making no representations or warranties about the condition, lineage, personality or temperament of the dog.
- I will give the dog proper food, water, shelter, affection, exercise and medical treatment when necessary, including booster shots. I agree to have the dog examined by a licensed veterinarian within 2 weeks of adoption.
- I agree that the dog will always wear an I.D. tag.
- I agree that the dog will not be used solely as a guard dog. I will never tie the dog to the end of a rope or chain, and under no circumstances will I let the dog run loose unattended in the neighborhood.
- I agree that if I cannot keep this dog for any reason, I CANNOT GIVE AWAY OR SELL HIM/HER. I must do one of the following:
- Return the dog to Rover Rescue.
- Obtain approval from Rover Rescue to transfer ownership of the dog to a friend or relative. Rover Rescue must approve the new adopter and the new adopter will be required to sign an agreement similar to this one.
- Continue to board the dog for a brief time, allowing Rover Rescue to actively seek a new home.
- I will notify Rover Rescue and the microchip company immediately if I have any change of address or telephone number.
- I agree that Rover Rescue may make a follow-up visit at a mutually convenient time, to ascertain that the above conditions have been satisfied. In the event that I do not comply with the terms of this Agreement, or the dog is abused or neglected, one of Rover Rescue’s remedies will be to recover the dog from me upon demand. Promptly after the demand Rover Rescue will come to my residence and I will surrender the dog to Rover Rescue immediately. In addition, without waiving any of Rover Rescue’s rights under this Agreement, if I do not surrender the dog to Rover Rescue, I will owe a payment in the amount of $500.00 as just and reasonable liquidated damages to compensate Rover Rescue for the costs and expenses in connection with my breach of this Agreement.
- Rover Rescue is not liable for any claims, legal actions, losses, injuries, damages, costs, expenses or liabilities whatsoever in connection with my adoption or ownership of the dog.
- PRINT NAME:
- STREET ADDRESS:
- CITY, STATE, ZIP:
- HOME PHONE #:
- WORK PHONE #:
- CELL PHONE #:
- E-MAIL ADDRESS:
- DRIVER’S LICENSE #: