Pet Rescue Adoption Application Form

Do you have experience with special needs Great Danes

YesNo

Name*

First NameLast Name

Age*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number (Mobile)*

Area CodePhone Number

Phone Number (Work)*

Area CodePhone Number

Phone Number (Home)*

Area CodePhone Number

E-mail*

example@example.com

Do you have children in the home? If yes, list the ages.

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

I / We live in a*

Do you have a fenced in yard?*

YesNo

How high is your fence?*

How many pets do you have? *

What is the breed of your pet?*

Your pets ages? *

What sex is your pet *

MaleFemale

Is your pet spayed / neutered?*

YesNo

Where does the pet stay (be confined) while you are out?*

Is your pet used to other pets?

YesNoOther

How do you discipline your pets and why? (describe)*

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

YesNo

Number of hours (average) pet(s) spends alone*

What is the animals name that you are interested in adopting?

Do you have a regular veterinarian?*

YesNo

Veterinarian’s name*

Clinic Name*

Clinic's Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Clinic's Telephone*

Area CodePhone Number

Signature

By signing and clicking the continue button, I agree to Marlee’s Kisses adoption process, I agree to and will undergo a homecheck, and interview at the discretion of Marlee’s Kisses. I understand Marlee’s Kisses will check my references including veterinary and personal. I understand there is an adoption donation associated with adoption of a pet from Marlee’s Kisses and that it is tax deductible according to IRS 501(c)3 guidelines. I understand this donation will ensure the organization is equipped to rescue another homeless pet. I understand there is no "cooling off" period, and that if I no longer want or can no longer care for my adopted pet, I agree to notify Marlee’s Kisses BY EMAIL and provide a 14 day period to allow Marlee’s Kisses to make arrangents for my pet to be taken back into the rescue. I agree to indemnify and hold harmless Marlee’s Kisses 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. I understand that Marlee’s Kisses will disclose any of the pet's health or behavior issues known by the above named rescue group before adoption is completed. 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 Marlee’s Kisses and provide transport to where Marlee’s Kisses deems appropriate. By signing and clicking the continue button, I verify all of the above information is true and accurate.

Marlee’s Kisses

Adoption application, Contract, and Waiver

Pet's Details