Adoption Application

Please review the application and ENSURE ALL INFORMATION IS COMPLETED AND LEDGIBLE without phone numbers, email, and vital information missing.
PLEASE COMPLETE ENTIRE FORM
Animal Name
Animal Choice
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number

Area CodePhone Number
Email
example@example.com
Governement Issued ID#/Drivers License
ID State
Current & Previous Pet History
Do you currently own any pets?
List Pets Currently Owned Below: (Name, Age, Breed, Species)
Spay or Neutered?
What happened to your last pet?
If your pet died or you gave it to an Animal Shelter/Rescue Group, please provide a reason
Veterinarian you currently or intend to use:
Where will this animal be housed?
If in a crate, approximately how many hours per day?
Is your yard fenced?
Outside - how will you contain the animal to your property?
WHO WILL BE LIVING WITH THE ANIMAL: How many adults over 18? (Please list names, ages and if any physical limitations or illnesses or any equipment an animal would need to navigate including but not limited to a wheelchair, walker, oxygen tank and hoses, etc that would need to be considered in placing the right animal to meet your families needs. Some dogs do not do well in a home with a lot of things to navigate and some do not understand many body and mind illnesses, etc.
WHO WILL BE LIVING WITH THE ANIMAL: How many children under 18? (Please list names, ages and if any physical limitations or illnesses or any equipment an animal would need to navigate including but not limited to a wheelchair, walker, oxygen tank and hoses, etc that would need to be considered in placing the right animal to meet your families needs. Some dogs do not do well in a home with a lot of things to navigate and some do not understand some body and mind illnesses, etc.
Residence Information
Do you own or rent your home?
Length of time at current residence
If your landlord requires you to pay a required pet deposit or increased rental fee, are you willing to do this?
Do you intend to move or relocate in the foreseeable future?
If yes, are you willing to ensure the animal will be allowed at your new home?
You must have landlord permission to own a pet. We will call to verify. You may not adopt a pet from HSHC if your landlord does not allow pets. NO EXCEPTIONS
Landlord Name
Landlord Phone Number

Area CodePhone Number
Falsifying landlord information will result in appropriate legal action, including, but not limited to, revocation of the adoption contract at which time I give permission for an HSHC representative to enter my property and repossess the animal listed above. I agree that I will be liable for any and all costs and fees associated with HSHC having to repossess said animal including but not limited to all expenses incurred for travel, court costs, attorney fees and any further restitution the court deems fit.

90% of all animals surrendered to animal shelters are because the owner is moving or has moved and their pets are not allowed. There are numerous places that allow pets; some require pet deposits and additional monthly fees. Pets are a forever commitment. If you cannot afford to pay additional monthly fees for them, please do not adopt. It is the owners responsibility to verify with their potential landlord, before committing to the lease, whether pets are allowed.

PLEASE READ, INITIAL, SIGN & DATE THE ADOPTION CONTRACT

Please read carefully and initial each item stating that you agree and understand the terms of this LEGALLY BINDING Adoption Contract.
1. ALL animals must be spayed or neutered. NO EXCEPTIONS. If you are adopting a puppy and/or kitten, this adoption is NOT final until the surgery has been performed & is considered an “Adoption in Process” but does not mean that you are not responsible for all expenses incurred for said animal plus abiding by #5 below. Once the animal is fixed the "Adoption in Process" will become "Final Adoption." Failure to keep your spay/neuter appointment will result in the repossession of the animal. I agree that if I do not contact HSHC to inform them that I need to reschedule or make other arrangements I will return said animal. If I do not return the animal immediately I give permission for an HSHC representative to enter my property and repossess said animal. I agree that I will be liable for any and all fees associated with HSHC having to repossess the animal including but not limited to all expenses incurred for travel, court costs, attorney fees and any further restitution the court deems fit.
Initial to agree.
2. The Humane Society of Henderson County (HSHC) has the right to refuse to adopt any animal or to deny any person for adoption. Previous owner surrenders will not be allowed to adopt an animal from HSHC depending on extenuating circumstances.
Initial to agree.
3. HSHC DOES NOT GIVE REFUNDS OR EXCHANGES ON ANIMAL ADOPTIONS. ALL ADOPTIONS ARE FINAL. (If you have dog(s) and/or small children a meet and greet with the dog you are interested in adopting needs to be scheduled before the dog will be released to you unless there are extenuating circumstances where a dog can't be transported for a meet and greet!
Initial to agree.
4. It is imperative to have your new pet examined by a veterinarian within 7 days of the adoption. The Vet can check your pet’s health and give you valuable information regarding warning signs of illness. With any new pet, it’s possible they may have been exposed to diseases or illness that may not show symptoms for a few days to several weeks. HSHC will not knowingly adopt out a sick animal. Even if the animal you chose is waiting to be altered you are responsible for expenses incurred for said animal including but not limited to all illnesses, injuries, medications, food & fees. Get the animal to the vet for care and contact HSHC during business hours. Pet Ownership involves medical care, from routine to emergency. Any and all veterinary fees incurred are the sole responsibility of the Adopter. The Humane Society of Henderson County does not routinely test for Heartworms, FIV, FIP, or FeLV. All testing is the responsibility of the new owner.
Initial to agree.
5. Puppies and kittens will receive their three (3) rounds of vaccines, which will be three (3) weeks apart at the shelter and one (1) Rabies vaccine will be administered by our vet when they are altered to complete the vaccination series. Vaccines must be given in a series to be complete or as recommended by your veterinarian. We highly advise that you to talk to your veterinarian about Leptospirosis vaccine for puppies and dogs. Failure to fully vaccinate your pet puts it at risk of contracting contagious and often fatal diseases. During the three (3) weeks you are waiting to complete the three (3) series of vaccines please do not allow your puppy and/or kitten to be exposed to the ground or taken into public. They are highly susceptible to catching diseases such as Parvo, Distemper, Bordetella and other illnesses. We advise that you do not expose puppies and/or kittens to public areas and people for at least six (6) months.
Initial to agree.
6. I understand that I am required by Kentucky State Law to have my animal vaccinated yearly by a licensed veterinarian against Rabies beginning at 4 months of age.
Initial to agree.
7. I agree to abide by all state and local city/county laws & ordinances pertaining to the containment and care of this animal, including, but not limited to, care, city/county license, noise, odor, confinement, and control. City/county tags are available in our office at $5 plus tax.
Initial to agree.
8. It is your responsibility as the Adopter person(s) to maintain and secure your animal(s) to ensure they do not reproduce prematurely and illegally while awaiting their vet appointment to alter. If a dog/cat is pregnant at time of spay appointment, all decisions will be made by the Humane Society. Any puppies and/or kittens born while still in "Application in Process" will be the sole ownership of the Humane Society. If you have an unaltered female you are breeding KY STATUTE 258.255 states every female dog in heat shall be confined in a building or secure enclosure in such a manner that the female dog cannot come in contact with a male dog except for a planned breeding which requires a visit from Henderson County Animal Control to approve the facility and a Breeders License that costs $50 for every breeding female and every breeding stud.
Initial to agree.
9. I agree to feed animal appropriate, age appropriate, healthy, edible food to this animal daily; to provide clean drinking water at all times; and to provide it with adequate shelter from the elements, including adequate shade, even if outside temporarily.
Initial to agree.
10. I agree that an unannounced home visit may be performed by an HSHC Representative at their discretion.
Initial to agree.
11. I understand that I can not stop payment on my check or credit card. If I do so, a Complaint will be filed with the Henderson County Attorney. Returned checks will be turned over to the County Attorney for prosecution. Court fines, fees and additional charges may be associated with these actions.
Initial to agree.
12. In the event that you are no longer able to keep this animal, you must return this animal to the Humane Society of Henderson County *NO EXCEPTIONS* . You may not sell, give away, abandon, kill or surrender to any other facility, regardless of where you live or the distance from HSHC. If I do not return the animal immediately I give permission for an HSHC representative to enter my property and repossess said animal. I agree that I will be liable for any and all costs including but not limited to all expenses incurred for travel, court costs, attorneys fees and any further restitution the court deems fit.
Initial to agree.
13. HSHC reserves the right to repossess the animal in the event of false information provided by the Adopter on this application or the home is found to be injurious and/or puts health and/or safety in danger. If, for any reason HSHC has deemed that the animal has been put in injurious and/or their health and/or safety in danger I give permission for an HSHC representative to enter my property and repossess said animal. I agree that I will be liable for any and all costs including but not limited to all expenses incurred for travel, court costs, attorneys fees and any further restitution the court deems fit.
Initial to agree.
14. THE HUMANE SOCIETY OF HENDERSON COUNTY DOES NOT ALLOW ANY OF OUR ADOPTED CATS TO BE DECLAWED. I understand and agree that I cannot get any cat that I adopt from HSHC declawed for any reason. If I declaw the cat in violation of this Contract I give permission for an HSHC Representative to enter my property and repossess said animal. I agree that I will be liable for any and all costs including but not limited to all expenses incurred for travel, court costs, attorneys fees and any further restitution the court deems fit.
Initial to agree.
15. THE HUMANE SOCIETY OF HENDERSON COUNTY DOES NOT ALLOW ANY OF OUR ADOPTED DOGS TO LIVE ON A CHAIN, ANY TYPE OF LEAD/TETHER, A DOG RUN NOR IN A KENNEL OUTSIDE. (we do understand if you do not have a fenced yard or underground fence that you may need to use a qualified and safe lead or a kennel for potty breaks. All kennels and bathroom areas must be maintained and kept clean.) PLEASE BE AWARE THAT DOGS CAN GET ANY TYPE OF LEAD/TETHER/CHAIN AROUND THEIR NECKS QUICKLY EVEN IF A FAST POTTY BREAK, THEREFORE NEED TO BE SUPERVISED FOR THEIR SAFETY. If I do not abide by the terms of this Contract I give permission for an HSHC Representative to enter my property and repossess said animal. I agree that I will be liable for any and all costs including but not limited to all expenses incurred for travel, court costs, attorneys fees and any further restitution the court deems fit.
Initial to agree.

By signing, I do hereby state that I am at least 18 years of age and have read, understood and agree to all the terms and conditions of this contract.
Signature
Date

MonthDayYear
Date
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Please review the application and ENSURE ALL INFORMATION IS COMPLETED AND LEDGIBLE without phone numbers, email, and vital information missing.