German Shepherd Puppy Adoption form

Adoption Application, Contract and Waiver

Perspective Pet Parent*

First NameLast Name

Name of litter you wish to adopt from*

Email Address*

Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Do you own any pets?*

Pet Name(s)

Pet Breed(s)

Pet's disposition and behavior towards other dogs?

Please provide your veterinarian's name and phone number:

Do you own or rent your home?*

OwnRent

Do you have a yard?*

YesNo

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

What is your landlord's pet policy?*

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

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

YesNo

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

If you answered "Yes" to the above question, please provide detail:

How many hours per day would the pet be alone?*

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

YesNo

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

By clicking the submit button, I agree to Hartzler's German Shepherds adoption process, will undergo a homecheck, and interview at the discretion of Hartzler's German Shepherds.
By clicking the submit button, I understand Hartzler's German Shepherds will check my references including veterinary and personal.
By clicking the submit button, 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 Hartzler's German Shepherds BY EMAIL and provide a 14 day period to allow Hartzler's German Shepherds to make arrangents for my pet to be taken back..
By clicking the submit button, I agree to indemnify and hold harmless Hartzler's German Shepherds 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 Hartzler's German Shepherds 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 Hartzler's German Shepherds and provide transport to where Hartzler's German Shepherds deems appropriate.
By clicking the submit button, I verify all of the above information is true and accurate.

Signature of Potential Pet Parent*