SAVINGMADESAVY

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number (Mobile)*

Area CodePhone Number

E-mail*

example@example.com

Which Fur baby are you ready to adopt?*

How did you hear about us*

Do you own or rent?*

OwnRent

Do you have a fenced in yard?*

YesNo

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

YesNo

Will you crate your pet?*

YesNo

How many hours of the day will the pet be alone at home?*

If you have to leave town, emergent or planned, where will your pet stay?*

How will you deal with behavioral issues such as barking, chewing, destructive behavior, bathroom accidents indoors, or unruly leash behavior in your pet? *

Do you own any other pets? If yes, how many? (Cat or dog)*

What is the breed of your pet?*

What is your pets disposition and behavior toward other dogs? *

Is your pet male or female?*

YesNoN/A

Is your pet spayed / neutered?*

YesNoN/A

Please provide one reference including name and phone number. *

Is your pet used to other pets?

YesNoOther

Do you have a regular veterinarian?*

YesNoN/A

Veterinarian’s name

Clinic's Telephone

Area CodePhone Number

Have you ever been convicted of an animal related crime, such as animal cruelty, animal theft, and or animal abandonment? (If yes please explain in detail) *

I agree not to have the dog attack-trained nor shall I use it for any purpose other than companionship. I will not have the dog’s ears cropped nor will I have its tail docked. I will never allow any physical, mental, or emotional abuse of the dog.*

Yes

I agree to treat the Fur Baby as an indoor pet and household companion, not as an outdoor pet. This means that the Fur Baby must be kept inside the home in a safe place at all times.*

Yes

I agree to provide the Fur Baby with humane treatment at all times. This means providing the Fur Baby with proper food, fresh water, proper shelter and exercise, and allowing a reasonable amount of time for the Fur Baby to adjust to new surroundings.*

Yes

1. I allow to use my likeness or pet in any photograph, video or other digital media (“Photos”) taken or to be taken on or during any affiliations with Tranquility Sanctuary in any and all of its publications, including print or web-based publications

2. I authorize Tranquility Sanctuary to copy, edit, enhance, crop or otherwise alter any Photo for use in their publications. I also waive any rights for approval or inspection of any Photos.

3. I understand and agree that all Photos are the property of Tranquility Sanctuary, and will not be returned to me.

4. I acknowledge that I am not entitled to any compensation or royalties with respect to the use of the Photos.

5. I agree to release and forever discharge Tranquility Sanctuary and its affiliates, successors and assigns, officers, employees, representatives, partners, agents and anyone claiming through them, in their individual and/or corporate capacities from any and all claims, liabilities, obligations, promises, agreements, disputes, demands, damages, causes of action of any nature or kind, known or unknown, which I, and anyone claiming on behalf of me, may have or claim to have against Tranquility Sanctuary in connection with this Release.

I confirm I have carefully read and fully understand all the provisions of this Photo Release Form and am freely, knowingly and voluntarily signing.

Agreement*

By clicking the submit button, I agree to Tranquility Sanctuary adoption process and will undergo a interview at the discretion of Tranquility Sanctuary. By clicking the submit button, I understand Tranquility Sanctuary will check my references including veterinary and personal. By clicking the submit button, I understand there is an adoption donation associated with adoption of a pet from Tranquility Sanctuary 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 and therefore, adoption donations and deposits are non refundable. By clicking the submit button, I agree to indemnify and hold harmless Tranquility Sanctuary 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 Tranquility Sanctuary 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 at any time, I will be directed to surrender my pet back to Tranquility Sanctuary and provide transport to where Tranquility Sanctuary deems appropriate. I understand there are NO REFUNDS. I understand that there is no guarantee of any kind as to the health, temperament, training or age of the Pet. I understand that the Tranquility Sanctuary, its agents and employees make no representation or guarantee of any kind, either explicitly or implicitly, as to the health, temperamental, mental disposition or training of the Pet. Release of Liability: The Adopter, and for his/her spouse, heirs, executors, personal representatives and assigns, agrees never to bring a claim or suit against Tranquility Sanctuary. The Adopter releases the Tranquility Sanctuary and its directors, founders, employees, officers, agents, representatives, contractors, volunteers, successors and assigns from all liability arising from the adoption or behavior or actions of the Pet. The Adopter understands that this agreement discharges the Tranquility Sanctuary and its directors, founders, employees, officers, agents, representatives, contractors, volunteers, successors and assigns from any liability to the Adopter and his/her spouse, heirs, executors and assigns, with respect to bodily injury, personal injury, illness, amputation, scarring, death, property damage or other loss that may result from the adoption or behavior or activities of the Pet. The Adopter releases the Tranquility Sanctuary and discharges the Tranquility Sanctuary and its directors, founders, employees, officers, agents, representatives, contractors, volunteers, successors and assigns from any liability for Tranquility Sanctuary’s own negligence or liability that may result in bodily injury, personal injury, illness, amputation, scarring, death, property damage or other loss to the Adopter. Indemnity Agreement: The Adopter, and for his/her spouse, heirs, executors, personal representatives, and assigns, agrees to indemnify and hold the Tranquility Sanctuary harmless for all bodily injury, personal injury, illness, amputation, scarring, death, property damage or other losses, including attorney’s fees and costs of litigation, that result to anyone else or any other entity because of the Adopter’s negligence or liability. This includes lone acts or omissions by the Adopter as well as the combined acts of the Adopter with others. By clicking the submit button, I verify all of the above information is true and accurate.

Signature of Potential Pet Parent *

Adoption Application

A Forever Home