Adoption Application
Rooster Haus Rescue
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email address
*
example@example.com
Phone number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Which animal are you interested in adopting?
Why are you interested in adopting?
*
What type of residence do you live in?
*
House - Urban
House - Rural
Apartment/Condo
Townhouse
Mobile Home/RV
Other
Do you rent or own your residence?
*
Rent
Own
Landlord's phone number and/or email address
*
Do you have any restrictions in your lease on keeping animals? If so, please explain the restrictions.
*
Do you have any zoning restrictions or HOA rules against keeping the type of animal you're interested in adopting?
*
Yes
No
Provide the name, age, and species of all other animals that reside with you.
*
Describe, in detail, the area that this animal will have access to during the day. Include the approximate size of the area, the type of fencing, whether the animal will share the space with any other animals, and the considerations you've taken to ensure adequate protection from predators.
*
Will this animal be kept inside a shelter at night?
*
Yes
No
Describe, in detail, the shelter that you have for this animal. Include the size, flooring material, whether it has a roof and a locking door, and how you will ensure that the temperature is kept at an appropriate and safe level during extreme weather.
*
Please provide pictures of the living area and shelter intended for this animal.
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Do you consent to a home visit by a representative of Rooster Haus Rescue?
*
Yes
No
Have you ever surrendered an animal? If so, please explain the circumstances.
*
Do you agree not to use this or any other animal for eating, breeding, fighting, or exhibition?
*
Yes
No
Do you have access to an avian vet? If so, please provide their name and the name of their practice.
*
Do you agree to care for this animal as a companion, and to provide compassionate care for the lifetime of this animal?
*
Yes
No
In the event that you ever need to rehome this animal, do you agree to notify Rooster Haus Rescue immediately and allow us to handle the rehoming process?
*
Yes
No
Is there anything else you'd like us to know?
IMPORTANT: All of the information I have provided is true and complete to the best of my knowledge. I agree to follow all rules and policies of Rooster Haus Rescue. I understand it is my decision on whether to adopt an animal or not. I will not hold Rooster Haus Rescue responsible for any damage, injury, or harm caused directly or indirectly to any person or property by any animal that I agree to adopt. Rooster Haus Rescue, at its sole discretion, reserves the right to refuse any applicant for any or no reason. I agree that I will not make any claims against, sue or attach any property of Rooster Haus Rescue, its directors, officers, agents, employees, and/or volunteers for any injury or damage caused by any animals adopted from Rooster Haus Rescue. By submitting this application, I agree to all stated policies, releases, and waivers.
*
Agree
Signature
Submit
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