Lumpy Lizard Reptile, Poultry, and Exotics Rescue Adoption Application

Lumpy Lizard Reptile, Poultry, and Exotics Rescue Adoption Application

All questions are required to apply to adopt an animal from Lumpy Lizard Reptile, Poultry, and Exotics Rescue. Filling out this form does not guarantee that you will be approved for adoption. All references will be checked.
Your name*
First & Last Name
Your Email*
Your Phone Number*

Area CodePhone Number
Phone Type*

CellHomeWork
Your Address (and where the animal will live)*

Street Address

Street Address Line 2

CityState

Zip Code
You live in a:*

Single Family HomeDuplex/TwinCondo/TownhomeTrailerApartment
Do you rent or own this property?*

RentOwn
If you rent, you must provide a written letter from your landlord or a copy of the section of your lease stating that you are allowed to have this type of animal and showing any limitations within one week of submitting this application. No animals will be placed in your home until this is received, even if you are otherwise approved to adopt. I acknowledge I have read this policy.*

I am a renter and I acknowledge that I have read this policy.I own my home.
Are you planning to move in the near future?*

YesNo
If moving soon, to what city/state?
Full names and ages of all residents of your home (adults/children)*
List all pets currently living in your home, regardless of species. If you have no other pets, please state "no other pets". *
List all pets that previously lived in your home, regardless of species, and why they no longer live in your home (deceased, rehomed, etc). If you have had no other pets, please state "no other pets". *
Have you adopted from us before? *
Which kind of animal are you applying to adopt?*

SnakeIguanaBearded DragonTurtleTortoiseGeckoChameleonTeguMonitorFrogRodent (degu, mouse, rat, hamster, guinea pig)Sugar gliderPoultry (chicken, duck, guineafowl, turkey)RabbitOther
Who are you applying to adopt? (if known) *
Have you ever had or do you currently have this species?*

YesNoOther
If you answered yes to the previous question, tell us about your experience with the animal and why they are no longer in your care, if applicable.
When will you be ready to adopt this animal?*

Within a weekWithin a monthNo timeline, just researching
Is anyone in your home allergic to or fearful of the animal you're planning to adopt?*

YesNo
If you answered yes to the previous question, explain how this will be addressed.
Have you discussed this adoption with all members of your household?*

YesYes, adults have discussed. Kids don't know yet.No
Please be aware that pets given as gifts are often returned to shelters or released. With this in mind, make sure that any animal you are adopting will be a permanent resident. Please, NEVER release an animal into the wild. We will take animals back if they're the wrong fit for your family!
Describe in detail the kind of enclosure planned for the animal and where it will be located. Be as specific as possible and include the size of the current enclosure, as well as how you will handle enlarging the enclosure as the animal grows. We may follow up for photos by email and your application will not be complete until we receive photos. *
Vet bills can be expensive. What will you do if a veterinary emergency occurs? *
Provide the name and phone number of your veterinary reference. Please call your vet and give notice that we will call. If you have not been to a vet before, let us know so we can help you identify one.*
Vet name, address & phone number
Additional reference (if desired, required if no veterinary contact established).*
Please check this box if you would like to schedule an in-home trial period to foster-to-adopt before finalizing the adoption. This period will be up to one month long.

I would like a trial foster-to-adopt period before committing. I understand I can return the animal at any time but that most animals take at least 2 weeks to get comfortable in a new environment.
Do you have any additional comments, questions or concerns?
By checking this box, you understand that you will be required to submit photos of the proposed enclosure/housing for this animal and a home-visit may occur.*

I understand the above.
You hereby agree that you will not use this animal in any sort of fighting, breeding, or cruelty. You will love and care for this animal for the rest of its life, and you are ready to commit to that. You will not use this animal for breeding. You also agree, that if for any circumstances you can no longer provide love and care for this animal, you will contact an admin of the group and explain your situation and will not take the animal to a shelter or other rescue, will not attempt to rehome the animal, or will not sell the animal. You understand that adopting under false pretenses will force us to pursue legal action against you.*

I understand the above, and have tried to the best of my knowledge to make sure all information is correct.
Adopter's Signature*
Signature date*
Please feel free to contact us at lumpylizardrescue@gmail.com if you have any additional questions. Thank you!
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