RCAR adoption form

Today Date

Date

Name

First NameLast Name

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.

Do you own or rent

OwnRent

Do you have any other pets in the home?

DogCatSmall animal (hamster,sugar glider, ferret, Guinea pig, etc)No

If you rent what is the landlord name and phone number

Do you have a yard?

Yes but no fenceYes with fenceNo

Name and phone number of veterinarian.

Will this pet be crated? If so for how long?

Have you ever relinquished a pet to an animal shelter, rescue or rehome? If so when and why.

Any children in home if so please list ages.

If you have other pets, are their vaccinations current?

Description of pet( will be filled in by River City Animal Rescue)

Is there a certain animal already in rescue that you are interested in? Please type in name or description of animal.

I understand by signing and or submitting this form I agree to the following:hereafter referred to as the adopter,hereby agree that the above described animal is being adopted by me solely as a pet for myself and/or my immediate family. I agree that I will not sell, give away or otherwise dispose of said animal to any person(s), dealer, retailer, auction, institute or any other entity for any reason. If at a later date I am unable or unwilling to keep this pet, I agree to return pet to River City Animal Rescue at no charge.
I hereby agree to care for the above described pet in a humane and responsible manner and to provide it with clean and adequate shelter, food, water and veterinary care. I further agree that said pet shall reside inside my home and shall not be allowed to roam freely.

I hereby understand and agree that River City Animal Rescue makes no representations or warranties, expressed or implied, about the above mentioned animal's temperament and is hereby absolved from any liability for future damages or injuries caused by said animal. I also understand and agree that River City Animal Rescue further gives no guarantees, expressed or implied, of the suitability of the animal to the adopter and/or his family.

I certify that all statements made by me on this adoption agreement are true and correct. I agree that the River City Animal Rescue has the right to confiscate the above described animal in the event that any statements made by me are found to be false and/or my check for the adoption fee is returned for insufficient funds.

Signature

River City Animal Rescue Adoption