Form

Date

Method Of Payment

Other

Payment Amount

Amount of Deposit

Deposit Paid

Name

First NameLast Name

Spouse Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Email

example@example.com

Driver's License No:

Does Your Diver's License Match Your Physical Address?

How Many Adults Live in Your Household?

How Many Children Live in Your Household?

Do you Own or Rent?

Name of Complex/Association?

If you rent, please bring a copy of your lease or rental agreement with you to the rescue. This is needed in order to have your adoption application approved. A current lease agreement is required and must show evidence of the pet policy, which includes weight and breed restriction for such address listed.

Vetnernarian

Name of Veterinarian's Practice

Veterinarian Address

Veterinarian Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

How did you hear about us?

What kind of energy level are you looking for in a pet?

What kind of exercise do you plan to provide?

Do you have a fenced in yard?

If yes, is it wood, aluminum, chain link or cement.

If yes, how high is the fence?

Do you have a pool?

How many hours a day would the pet be left alone?

Where will the pet be kept the majority of the day?

How many hours will the pet be be outside unsupervised?

Do you have animals at home?

If yes, what type of animal, breed, gender, and age of other animal(s)

Your new pet must be (check all that apply)

If other, please explain.

How much money monthly do you expect to spend for your pet for food, medicine, etc:

Under what circumstance would you give up ownership of your pet?

Would you declaw your pet?

Have you adopted from us before?

If yes, who and when?

Type of Animal

Desired Breed

Color

Age

Male or Female

Name of Pet

I agree that the animal adopted on this date blanks is for myself and not to be sold, adopted, or given to another party in any event and will be returned to the original owner, Lisa Hutchins, in the event the animal can no longer be cared for without requesting a fee. blank (Initial)

I agree that this animal will be spayed/neutered by six months of age (for puppies and kittens)blanks (Initial)

I agree that the animal lives in a private residence and will not be allowed outdoors without proper supervision. blanks (Initial)

I agree that the animal will not be altered in any way unnecessarily to their health and quality of life (ex. Cropping ears, declawing) blanks (Initial)

I agree to take care of the animal in a humane manner and be a responsible guardian. This includes providing adequate food, water, shelter, affection, and medical care. blanks (Initial)

I agree that the original caregiver, Lisa Hutchins, can contact me at a reasonable time to check on the adopted animal. blanks (Initial)

I agree that I have never been convicted of cruelty to animals at any time, and have no court orders saying that I cannot adopt an animal.blanks (initial)

I agree that there is no guarantee about the temperament or physical conditions of the animal being adopted and the original caregiver, Lisa Hutchins, is not responsible for any damages or injuries caused by the animal in the future or any medical conditions the animal may have.blanks (Initial)

I agree that this contract never expires for the lifetime of the animal. blanks (Initial)

This is a fill in the blanks field. Please add appropriate blank fields and text.

I agree that if the contact is broken or if the animal is an unsafe environment under the opinion of the original caregiver, Lisa Hutchins, to confiscate the adopted animal from my residence. blanks (Initial)

I agree to all of the above obligations of this contract and that I have signed truthfully and lack of truth will result in a breach of contract and that in the event of any such breach of contract, I authorize the original caregiver, Lisa Hutchins, to confiscate the adopted animal from my residence.blanks (Initial)

I authorize the above listed veterinarian(s) to supply information in regards to my pets to the original caregiver, Lisa Hutchins blanks (Initial)

I authorize the original caregiver, Lisa Hutchins, to contact the above listed landlord in regard to my pet and their pet policy. blanks (Initial)

This contract was executed at blanks (City, State) blank (Date)

Adopter

Form

Cozy Oak Exotic and Livestock Rescue Inc.

Animal Information

Terms of Contract