All4Them Dog Rescue Application

Fields marked with an * are required.

Name of all adults in the house:*

Age*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Home Phone:*

Area CodePhone Number

Work Phone:

Area CodePhone Number

Cell Phone:

Area CodePhone Number

Email*

example@example.com

Name of Pet you wish to adopt:*

Describe in detail the reason why you wish to adopt:*

Do you have any other pets?*

YesNo

If Yes, please list all their names, breeds, and ages:

Are all of these pets spayed/neutered and up to date on all vaccinations?*

YesNo

If NO, why?

Describe previous dogs you have owned. How long have they lived and ultimately, what happened to them?*

What is the name of your vet (He/She will be contacted for references):*

Your Vet's phone number:*

Area CodePhone Number

Do you have children that live in or visit your home?*

YesNo

If Yes, what are their ages?

Does any member of your family have any allergies to animals? If so how are they treated?*

Do you Own or Rent?*

If you RENT, does your landlord welcome pets?

Landlord Phone Number:

Area CodePhone Number

How many hours a day will the dog be alone?*

How much time can you spend with the dog?*

What type of enclosure are you planning to use for the dog?*

Where will the dog live and sleep?*

Have you ever given up a dog?*

YesNo

If YES, please explain:

Are you willing to take the time to work with the pet on housebreaking or chewing, if such problems arise?*

YesNo

How much time are you prepared to allow for your new pet(s) to adjust to your home?*

How much are you assuming it will cost to provide for this pet per year?: *

If you move will you take the pet with you?:*

YesNo

Under what circumstances would you return the dog?*

Reference name and phone numbers (2 please):*

Do you understand that dogs are NOT perfect, and that you will have to work with this dog? **

Yes

Thank you for filling out the All 4 Them Dog Rescue adoption application. Pet ownership is a serious commitment that the entire household needs to consider and agree to before the animal is adopted. We want to ensure that each adoptive household is aware of and willing and able to accept the physical and financial responsibilities of pet ownership. Not everyone that desires a pet is ready to properly care for one.
I understand all of the questions and have completely read the application and understand that this All 4 Them Dog Rescue dog MUST be indoors and this dog will not be chained/penned outside. I further understand that if for any reason I want to give up this dog, I will call All 4 Them Dog Rescue, and undergo a 14 day waiting period in which representatives of All 4 Them Dog Rescue will work with me to resolve any issues with the dog. I also under¬stand that a representative from the organization may visit the dog to ensure that it is well taken care of; if we find that the dog has been neglected or abused in any way or for any reason, we reserve the right to remove the dog from the premises. Your signature below authorizes us to do so as necessary, and automatically transfers ownership rights of said dog back to All 4 Them Dog Rescue at that time.

Signature (type your full name):*

Date*

Date

Witness

All 4 Them Dog Rescue makes no guarantees in reference to the health and/or temperament of the dog. The dog is adopted “AS IS” and the adopter assumes responsibility for the treatment of and all existing conditions or any other conditions of physical or temperament changes that may occur. While the rescuer makes every effort to place only healthy animals, the rescuer cannot guarantee the health of any animal. The rescuer shall not be held responsible for any medical expenses which may be incurred, hereby expressly excluding any implied or express warranties, merchant¬ability, or fitness for any particular purpose, including without limitation and warranties regarding health, temperament or whether the animal is housebroken. Any liability for dog bites will be yours once as soon as guardianship of the dog is transferred to you. All 4 Them Dog Rescue will not be held liable for any dog bite incidents after adoption. All 4 Them Dog Rescue does not refund donations if the dog is returned. This is a legally binding contract.

Signature*

Date*

Date

Witness