AVA'S ANIMALS RESCUE
AvasAnimalsRescue@gmail.com
Adoption Application & Contract
APPLICANT INFORMATION
Full Name
First Name
Last Name
Phone Number
Format: (000) 000-0000.
Email Address
example@example.com
Address
Street Address
Street Address Line 2
City, State, Zip Code
State / Province
Postal / Zip Code
ANIMAL INFORMATION
Animal Name
Breed / Color
Adoption Fees - $100 For Cats, $200 For Dogs
HOUSEHOLD INFORMATION
Residence:
Own
Rent
Live with Family
Other
RENTAL INFORMATION (IF APPLICABLE)
Landlord Name
Landlord Phone
Format: (000) 000-0000.
Pets Allowed?
Yes
No
Home Type:
House
Apartment
Condo
Mobile Home
Farm
Fenced Yard?
Yes
No
Type/Height:
Adults in Household:
Children:
Children Ages:
Everyone agrees to adoption?
Yes
No
Any pet allergies at home?
Yes
No
Hours pet will be left alone daily:
Where will the pet stay when alone?
Where will the pet sleep?
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CURRENT & PAST PET HISTORY
CURRENT & PAST PET HISTORY
Rows
Name
Species/Breed
Age
Spayed/Neutered
Vaccinated
Indoor/Outdoor
1
2
3
4
5
Veterinary Clinic Name:
Veterinary Phone Number:
Have you owned pets before?
Yes
No
Have you ever surrendered or rehomed a pet?
Yes
No
If yes, explain:
Have any pets been lost, stolen, injured, or died unexpectedly?
Yes
No
If yes, explain:
Have you ever been charged with animal cruelty, neglect, or abandonment?
Yes
No
If yes, explain:
PET CARE AGREEMENT
Will this pet be kept primarily indoors?
Yes
No
For dogs: Will the dog be chained or tethered outside?
Yes
No
If yes, explain:
How will behavioral or medical issues be handled?
Plans for the pet if you move, become ill, or pass away:
Are you financially prepared for routine and emergency vet care?
Yes
No
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PERSONAL REFERENCES
PERSONAL REFERENCES
Rows
Name
Relationship
Phone Number
Years Known
1
2
ADOPTION CONTRACT & AGREEMENT
1. The adopted animal will be treated humanely and as a companion animal.
2. The adopted animal will live primarily indoors and will not be allowed to roam freely.
3. The adopter agrees to provide proper food, water, shelter, veterinary care, exercise,
and attention.
4. The adopter agrees to maintain vaccinations as recommended by a licensed
veterinarian.
5. The adopter agrees that the animal will not be abused, neglected, used for breeding,
fighting, guarding, experimentation, or any illegal activity.
6. If the adopter can no longer keep the animal for ANY reason, the animal MUST be
returned to Ava's Animals Rescue and may not be sold, surrendered, abandoned, or
rehomed without permission.
7. The adopter understands that animals are unpredictable and Ava's Animals Rescue
makes no guarantees regarding health, temperament, breed, or future size.
8. The adopter assumes full responsibility for the animal and releases Ava's Animals
Rescue, its volunteers, fosters, and representatives from all liability arising from
ownership of the animal.
9. The adopter agrees to comply with all local and state animal laws and ordinances.
10. The adoption fee is non-refundable unless otherwise approved by the rescue.
11. Ava's Animals Rescue reserves the right to deny any adoption application.
12. False information may result in denial of adoption or reclaiming of the animal.
13. The adopter certifies all information provided is accurate and truthful.
SIGNATURES
Adopter Printed Name
Adopter Signature
Date
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Rescue Representative
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