Cat Adoption Application MD

Cat Adoption Application
Animals are for life. When you adopt an animal, it is a commitment you make to the animal, for the lifetime of that animal. By adopting a cat from Safe Haven Animal Shelter, you’re making a commitment to provide love, care, and medical treatment for the life of the cat, which can be up to 20 years. Adopting a cat is a serious commitment, but one that is incredibly rewarding.

If you are unable to make such a long-term commitment, we would be happy to have you become a foster parent instead or consider volunteering in other ways. It’s a great way to make a difference in an animal’s life without taking on such a long-term commitment.

* Please have patience as it can take up to 4 business days

for us to process this application and get back to you.*
Name of cat you're interested in*
Applicant Name*

First NameLast Name
Phone Number*

Area CodePhone Number
Email
example@example.com
Spouse or Co-Applicant

First NameLast Name
Phone Number

Area CodePhone Number
Email
example@example.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code
How long at present address
Describe the activity level in your home.

Have you ever adopted an animal from a rescue/animal control agency?

YesNo
If so, name of agency or rescue
Name of Veterinarian Current or Previous*
Phone Number Veterinarian*

Area CodePhone Number
Person name on vet records:*
List the companion animals that have been a part of the family during the last 10 years: (ALL YOUR CURRENT PET(S) INFORMATION MUST BE FILLED OUT.)
Are all current companion animals spayed or neutered?*

YesNo
If pet(s) are not spayed or neutered, please explain
For the pets that are no longer in your possession, please provide an explanation, giving as much detail as you can.

Please supply 3 personal references (not present household)

	Name	Phone	Email Address
1.
2.
3.

ADOPTION AGREEMENT

Please read each statement and initial on the indicated lines.
1) I agree to provide food, water, shelter, exercise, socialization, and veterinary treatment as my companion cat requires throughout its lifetime. *
Initials
2) Safe Haven Animal Shelter does not allow, nor does it endorse, the inhumane and painful declawing of felines. I agree to not declaw this cat.*
3) Safe Haven Animal Shelter makes no claims or representations as to the temperament, health, and/or mental disposition of this cat/kitten. The actions and behavior of cats can be unpredictable and may change after it leaves. Closely supervise around children until cat is comfortable in your home.*
Initials
4) Safe Haven Animal Shelter will not be responsible for any damage that my adopted cat may do to any person, animal, and/or property.*
Initials
5) I understand that ALL SHELTER ANIMALS ARE EXPOSED TO CONTAGIOUS DISEASES and while Safe Haven Animal Shelter screens to the best of our ability to ensure healthy cats/kittens. I understand that some diseases may have an incubation period during which at adoption time symptoms are not present. These diseases include a virus similar to the human cold known as Feline Upper Respiratory Infection. Treatment will be the responsibility of the adopter. This illness CAN be spread to existing cats. I understand that symptoms may appear after taking my cat/kitten home.*
Initials
6) Safe Haven Animal Shelter will not be responsible for any medical bills, including emergency and/or after hour care for present or future illness on my adopted cat/kitten or any other animals in the household.*
Initials
7) Safe Haven Animal Shelter requires that all adopted animals be spayed or neutered. I hereby agree that I if I wish to adopt a cat/kitten who is not already altered and prefer MY OWN vet to do the surgery it will be MY financial responsibility.*
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8) The undersigned applicant hereby grants Safe Haven Animal Shelter permission to confirm any information provided in this application with any appropriate third party source, including landlord, veterinarian, etc. The information obtained will be held in confidence and used only by Safe Haven Animal Shelter for purpose of this application.*
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9) I certify that all of the information is true and complete and I understand that if any false information, omissions, or misrepresentations are discovered, my application may be rejected. *
Initials
9) I also understand that this adoption application is sole property of Safe Haven Animal Shelter. It is specifically understood that Safe Haven Animal Shelter reserves the right to deny any adoption application at its own discretion. *
Initials
TO VISIT/MEET A CAT/KITTEN, YOU MUST READ AND SIGN THIS WAIVER/RELEASE FORM: I and family members agree to wear a face mask during a cat/kitten visitation/meeting and/or at a Safe Haven Animal Adoption event.Although precautions are taken, the risk to have contact with individuals who have been exposed to Covid-19 does exist and it is impossible to eliminate the risk that I and/or family member could be exposed to and/or become infected through contact with or close proximity with an individual with this disease.I hereby fully and forever waive, release, and hold harmless, Safe Haven Animal Shelter, including board members, foster homes, and volunteers, from actions, claims or every nature whatsoever, damages and judgements which I may have now or in the future against Safe Haven Animal Shelter for injuries or sickness to myself and family members, known or unknown, and arising out of myself or family member as a visit, volunteer, and/or prospective adopter of Safe Haven Animal Shelter. I, THE UNDERSIGNED, HAVE READ THIS WAIVER AND RELEASE AND UNDERSTAND ALL OF ITS TERMS AND I EXECUTE IT VOLUNTARILY AND WITH FULL KNOWLEDGE OF ITS SIGNIFICANCE.
Disclaimer: Safe Haven Animal Shelter reserves the right to reject any application based on information obtained on the application or home visit. Please understand that our primary goal is to ensure the health, happiness, and safety of our rescued cats.
Your Signature*

Clear
Spouse or Co-applicant Signature

Clear
Date*

MonthDayYear
Date
Should be Empty: