Clone of Pet Adoption Application Form

Livestock Adoption Application

Perspective Pet Parent *

First Name Last Name

Name of Pet You Wish to Adopt *

Email Address *

Phone Number *

Area Code Phone Number

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code Country

Do you currently own any pets? *

Pet Name(s)

Pet Breed(s)

Please provide your veterinarian's name and phone number:

Do you own or rent your home? *

Own Rent

If you rent, please provide your landlord's information here: *

Do you have a fenced property? *

Yes No

If "Yes" to the above, is it fenced? please describe

Do you have a barn or shelter? *

Yes No

If "Yes" to the above, Do you have a Barn or Shelter? please describe

Have you ever surrendered a pet you own to any animal shelter including a "low" or "no kill" shelter? *

Yes No

Are there children in the home? (If yes, please list ages) *

How do you plan to train the animal you are applying for? *

Please provide the names, emails, and contact numbers for 3 personal references: *

Have you ever been convicted of an animal related crime, such as cruelty to animals, animal theft, or animal abandonment? *

Yes No

If you answered "Yes" please provide a detailed description:

By clicking the submit button, I agree to Pits R Us All Breed Rescue & Adoptions adoption process, will undergo a homecheck, and interview at the discretion of Pits R Us All Breed Rescue & Adoptions.
By clicking the submit button, I understand Pits R Us All Breed Rescue & Adoptions has the right to check my references including veterinary and personal as listed above.
By clicking the submit button, I understand there is an adoption donation associated with adoption of a pet from Pits R Us All Breed Rescue & Adoptions. I understand this donation will ensure the organization is equipped to rescue another homeless pet.
By clicking the submit button, I understand there is no "trial" period, and that if I no longer want or can no longer care for my adopted pet, I agree to notify Pits R Us All Breed Rescue & Adoptions BY EMAIL and provide a 14 day period to allow Pits R Us All Breed Rescue & Adoptions to make arrangents for my pet to be taken back into rescue. I understand and agree not to rehome the pet or surrender the adopted pet to a shelter.
By clicking the submit button, I agree to indemnify and hold harmless Pits R Us All Breed Rescue & Adoptions against any losses, lawsuits, claims, injury, damages incurred by me or to any persons or property by my adopted pet, once adoption has been completed.
By clicking the submit button, I understand that Pits R Us All Breed Rescue & Adoptions will disclose any of the pet's health or behavior issues known by the above named rescue group before adoption is completed.
By clicking the submit button, I understand that if I no longer want my pet, or am no longer able to care for my adopted pet, I will be directed to surrender my pet to Pits R Us All Breed Rescue & Adoptions and provide transport to where Pits R Us All Breed Rescue & Adoptions deems appropriate.
By clicking the submit button, I verify all of the above information is true and accurate.

Signature of Potential Pet Parent *