North Augusta Pound Adoption Application

NORTH AUGUSTA POUND

Adoption Application, Contract and Waiver

Perspective Pet Parent*

First NameLast Name

Name of Pet You Wish to Adopt*

Email Address*

Phone Number*

Area CodePhone Number

Can we text you?*

Please add link to your Facebook or Instagram if able to provide

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Do you own any pets?*

YesNo

Are they spayed or neutered?

YesNo

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?*

Will you crate your pet?*

If you have to leave town, emergently or planned, where would your pet stay?*

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

Are there any situations where you would consider returning this pet or surrendering to a shelter? If yes, please explain. If No, then just put "None".*

I understand that owning a pet comes with the financial responsibility of providing food, basic vet care including yearly shots and exams, and funding in case the animal gets sick. Are you in a good financial situation to take care of this adopted animal and provide for his or her care?*

YesNo

I understand that every adopted animal from the North Augusta Pound must be spayed or neutered within 60 days of adoption. Puppies need to be spayed or neutered by age of 6 months. Failure to provide proof after this time period can result in a fine.*

YesNo

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

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, North Augusta Pound's adoption process.
By clicking the submit button, I understand NA Pound volunteers will check my references including veterinary and personal.
By clicking the submit button, I agree to indemnify and hold harmless the City of North Augusta and any rescue or partner organizations including FONAA against any losses, lawsuits, claims, injury, damages incurred by me or to any persons or property by my adopted pet.
By clicking the submit button, I understand that every adopted animal from the North Augusta Pound must be spayed or neutered within 60 days of adoption. Puppies need to be spayed or neutered by age of 6 months. If failure to complete this spay or neuter and provide proof within said 60 days, adopter is subject up to a $5000.00 fine.
By clicking the submit button, I verify all of the above information is true and accurate.

Signature of Potential Pet Parent*