Adoption Application

ONCE UPON A TAIL RESCUE

ADOPTION Application and Contract

Once Upon a Tail is a non profit rescue organization for homeless, sick, and injured dogs. It is our goal to get these dogs healthy and place them in permanent, loving homes where every member of the household is committed to their lifelong care. If you are willing to take on this responsibility, please complete the application below. Your application will be reviewed, and if qualified, we will proceed with setting up a meet and adoption.

ADOPTION APPLICATION INFORMATION
• Submitting this Adoption Application does not obligate you to adopt a dog. It simply allows us to check your application and set up a meet with a potential dog.
• This Adoption Application becomes a binding Adoption Contract only after approval by the rescue, and is effective on the date and time that the adoption payment is accepted by Once Upon a Tail Rescue.
• If you would like to Foster a dog by providing a temporary home until a permanent one is found, there is a separate Foster Application which must be completed. If you should decide to adopt a dog you are fostering at some point in the future, you must notify us immediately, go through a separate Adoption approval process, be approved for adoption, and pay the Adoption Fee to the rescue. If another adopter has already been approved and notified, a foster is no longer eligible to have the first option at adopting.

• You must be at least 21 years old or have the consent of your legal guardian to enter into this contract. Proof is required.

DOG'S Name that you are applying to Adopt*

If name unknown, just type a brief description of dog.

How did you hear about this dog?*

SECTION 1 - PERSONAL INFORMATION

Applicant's Full Name*

First Name Middle or MaidenLast Name

Spouse or Co-Applicant's Full Name (if applicable)

First Name Middle or MaidenLast Name

Cell Phone # *

Enter Primary # if no Cell Phone

Secondary # (Home/other)

Home or Other #

Email Address*

example@example.com

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Do you own or rent home?*

OwnRent

How long have you been at your current address?*

Please list # of Years and Months

If renting, please provide landlord's name along with phone # or website. By listing, I certify that Dogs are allowed by my landlord.

If not adopting for your household, who are you adopting for and why?

Date of Birth *

Date

If under 21, Please list Name & Phone # of your legal guardian.

Occupation*

If not employed, please just note that here.

Are you currently employed?*

YesNoStudent

Occupation/Employer*

SECTION 2 - LIVING ARRANGEMENTS

Under what circumstances or life changes have you had to, or would you have to give up a pet?*

Select ALL that apply from drop down

If you selected a response to the question above about having to give up a pet, you can provide additional detail here if you'd like to explain further.

How many people currently live or reside in the home including you?*

	# of Adults	# of Children	Ages of ALL Children in home
Residents in home

Where will your adopted dog primarily live?*

Please select an option from Drop Down

How many hours per day will your dog usually be left alone due to work, school, etc?*

Select # of Hours

Do you have a fenced yard that is fully enclosed on all 4 sides?*

YesNoOther

If Yes, please select fence height AND material(s)? (Select all that apply)*

Select all that apply from drop down

What is the usual activity level in your home?*

Please select an option from Drop Down

Are you willing and able to seek professional training for your adopted dog if needed?*

YesNoMaybe

If Yes, what is fence material?*

Select all that apply from drop down list

If something happens to you, or you have to move where dogs are not allowed, what would happen to the dog?*

SECTION 3 - HISTORY & EXPERIENCE WITH DOGS

*IMPORTANT - If you are considering adopting a PUPPY, we can't stress enough, that the puppy will only grow up to be a well-behaved adult dog, based on the time and resources you put into training them as a puppy. You MUST be prepared to teach them where to potty, what/when/where to eat, what to play with & chew on, what type of play is acceptable (no using their teeth), socialization with other pets & humans, basic obedience & manners, etc. Although foster families have started working on many of these items, puppies are not born with this knowledge, it must be taught at appropriate ages, and it takes time.

When was the last time you owned a dog?*

Please list # of years/mos ago or "own one now".

How many Total dogs have you owned in your life?*

Enter #

How many of the total dogs owned in your life were puppies? *

Enter #

How many dogs do you currently own?*

Enter #

How many cats do you currently own*

Enter #

If you indicated that a dog lives Inside & Outside, please provide details on when it is inside and when it is outside.

Have you ever had to surrender a pet you owned to any animal shelter including a "low" or "no kill" shelter?*

YesNo

If you answered "Yes" to surrendering a pet, please provide details:

Have you ever lost a dog to accident or escape?*

YesNo

If you answered "Yes" to losing a dog to accident or escape, please provide details:

List of CURRENT DOGS you own that are living at your home, inside and/or outside.

	Current Dog's Name	Breed or Breed Mixes	Age of Dog	Sex of Dog	Is Dog FixedY/N	Is Dog Up to Date on shots?	Is Dog On Year Round heart worm prevention?	Where does the dog primarily live?
Dog 1
Dog 2
Dog 3
Dog 4
Dog 5

Please list the Name and Phone # to the Veterinarian/Vet clinic you use for your CURRENT PETS. If more than one is used, please list all of them. *NOTE: IF THE RECORDS ARE UNDER ANOTHER NAME, PLEASE ALSO PROVIDE THAT NAME. Please note that by providing this information and signing this application, you have agreed for the veterinary clinic(s) listed to provide us with information about your current and/or past pets and relevant medical history.*

If you use heartworm prevention for your dog, what kind do you use, and where do you purchase it?

If you use flea prevention for your dog, what kind do you use, and where do you purchase it?

Please list the information for any PRIOR DOGS you've had in the last 7 years, living at your home inside or outside. *Please list the most recent dog at the top & continue to list in date order.

	Prior dog's Name	Breed or Breed Mixes	Dog Age when you last owned	Where is Prior Dog now?	Was Prior Dog Fixed?	Kept Up to Date on shots?	On Yr Round heart worm prevention?	Lived inside or outside?
Dog 1
Dog 2
Dog 3

Please list the Name and Phone # to the Veterinarian/Vet clinic you used for your PRIOR PETS, regardless of how long ago. If more than one was used, please list all of them and which dog(s) they treated. *NOTE: IF THE RECORDS WERE UNDER ANOTHER NAME, PLEASE ALSO PROVIDE THAT NAME.

If there is anything else we should know about you, why you want to adopt this dog, your living arrangements, current or prior dogs, or your application in general, please enter that information here.

AGREEMENT TO ADOPT

Adoption fee: PUPPY (< 1 Yr)=$325, ADULT = $275, SENIOR (10 Yrs +) = $200 Included cost of spay/neuter, microchip, heart worm & microfilaria test (if dog over 6 months upon intake), initial fecal test & deworming, initial heartworm prevention until adopted, core vaccines and examination by a licensed veterinarian, and any other services completed prior to adoption. If any of the services listed above have not been completed by the time of adoption, they must be scheduled and completed at an approved and participating veterinary clinic with Once Upon a Tail.

Please consider making an extra donation to help cover the cost of medical expenses for the many sick and injured dogs taken in by the rescue.
All original medical records will be transferred to adopter. It is adopter’s responsibility to maintain these records in a secure place for future reference. Should all records not be available at time of adoption, the rescue will promptly mail to adopter once received.
If during the first 3 days, you decide the dog is not right for your family, Once Upon a Tail agrees to issue refund, provided that you contact us during that 3 day period and make arrangements to promptly return the dog on the date and to the place designated and agreed upon by the rescue. The Vet information Packet and Rabies Tag (if issued) must also be returned in order for a full refund to be processed, whether return is requested by you or the rescue.

PLEASE READ CAREFULLY TO UNDERSTAND WHAT YOU ARE AGREEING TO!

By entering his/her signature below, the ADOPTER hereby agrees to the following terms and conditions. Your electronic signature below has the same effect as an original signature and will constitute your acceptance of the terms herof:

On the effective date and time of this adoption agreement, the Adopter, assumes 100% complete and total liability for the adopted dog.
Adopter understands that an adopted dog may need some additional time and behavioral and/or potty training, depending on their background and whether they were previously living in a home. Adopter agrees to remain patient and provide the help needed for the dog to work through this adjustment period.
Adopter acknowledges that Once Upon a Tail is providing an animal for adoption on an "AS IS" basis. Once Upon a Tail cannot guarantee breed mix or age, and is providing it's best estimate based on experience and veterinarian estimation. Once Upon a Tail makes no representation as to the temperament or medical condition of the dog being adopted. All medical records received by Once Upon a Tail are provided to adopter.
If Adopter chooses to have the animal checked by their own licensed veterinarian, it is at their own cost. Any medical issues which may be present shall be brought to the attention of Once Upon a Tail within 30 days of adoption, who may, at its own discretion, assist in the treatment process. Upon request, Adopter will provide Once Upon a Tail with copies of those vet records.
Adopter shall allow a representative of Once Upon a Tail to visit/check on the dog on a random basis during the first year of adoption, notify Once upon a Tail of any change of address during this time period, and maintain contact with Once Upon a Tail during the first year of adoption, to help ensure a smooth transition of this dog to my family. Should Once Upon a Tail find that the dog is not being cared for in compliance with this agreement, or in violation of local or state laws, Once Upon a Tail reserves the right to seize the dog for the safety & welfare of the dog.
Adopter shall provide for the dog's physical and emotional needs including: proper diet & nutrition, water, housing, exercise, medical care, vaccinations, & monthly heartworm preventative for the remainder of it's natural life. Adopter understands that owning a dog comes with recurring monthly and annual expenses and acknowledges they are financially prepared to cover and prioritize these required expenses.
Adopter shall comply with all state and local laws pertaining to the care and keeping of the dog, including leash laws, licensing, registration and rabies vaccinations/tags.
Adopter agrees that the dog will be kept as an Inside Dog, and be taken outside only with supervision for exercise, play and potty needs.
Adopter agrees not to abandon, give away, sell or trade the dog for the duration of the dog's natural life. Adopter agrees to contact Once Upon a Tail in the event that the dog cannot be kept due to unforeseeable circumstances in the future. Should re-homing be necessary, it must be done in conjuntion with the rescue. Under no circumstances can the dog be sold, returned to a Veterinary office, PetSmart or any other adoption event facility, nor surrendered to a shelter or another rescue group.
Adopter agrees to make every reasonable effort to locate the dog should it escape or become lost or stolen, including immediately notifying Once Upon a Tail. The rescue will provide information and/or assistance to help locate the missing dog.
It is a requirement of this Rescue that ALL animals adopted be spayed or neutered by 6 mo of age. If you have adopted a puppy too young for this procedure, you will be required to have this done at an approved and participating Once Upon a Tail Veterinary facility. If the adult dog you have adopted has not yet been spayed or neutered, you are required to honor the scheduled appointment or reschedule it during a 10 day time frame. If an appointment has not been scheduled or has not been done due to the health of the dog, you will have 45 days after the adoption to have this procedure done at one of the rescue's approved clinics. Should the animal not be altered prior to this date, you are in violation of this contract and the rescue will take the necessary steps to seize the dog for the safety & welfare of the dog.
Puppies require a series of booster shots spaced 3 weeks apart. This is included in your adoption fee. The 1st set of shots is given @ 6 weeks of age, along with the initial fecal test and deworming. All subsequent fecal tests and deworming medication, if needed, are the responsibility of the adopter. Should the adopter choose to have the remaining shots at another veterinary clinic other than the one approved by the rescue, payment responsibility is that of the adopter. Adopter must submit proof to Once Upon a Tail that this service was performed within the proper timeline. By signing I understand what services are included in the adoption fee and that the cost of any other service or medication is my responsibility.
Microchip must be done with a chip provided by the rescue, so that in the unfortunate event that the dog is lost, it will also be tracked back to Once Upon a Tail Rescue. It is included in the adoption fee, but should I choose to have the microchip done elsewhere, I must contact the rescue to obtain the proper chip, and pay an additional $5 additional fee for rescue to ship & process the chip. The cost of implanting the chip elsewhere, is also the responsibility of the adopter.
If all included services have already been completed at the rescue's Veterinarian, I must make a visit to my veterinarian within the first 30 days of adoption. If I currently do not have a veterinarian, I understand that I must establish one, bring the dog to it's first appointment, and contact the rescue. with the name & phone number of my new veterinarian within this timeframe.
If Once Upon a Tail discovers any detrimental or false information received regarding the welfare of this animal or if we feel the placement is incorrect at any time, Once Upon a Tail reserves the right to seize the animal for the safety & welfare of the dog. Should this occur, I agree to promtly return the animal it to the rescue within 24 hours of notification.
I understand that Adoption fees are fully earned by the rescue & non-refundable for any reason after 30 days.
Should adopter pay with a check and the check is returned for Insufficient Funds or any other reason, the adopter agrees to immediately replace with Cash, Money Order or Venmo, including a $30 NSF Fee.
I hereby grant my permission for Once Upon a Tail Rescue, PetSmart LLC and its parent entities, affiliates, and subsidiaries (collectively, "PetSmart") and PetSmart Charities, Inc. and PetSmart Charities of Canada (together, "PetSmart Charities"), to use any photos or videos taken of me or given by me during facilitation of the adoption of my pet. I agree that the permissions given in this release further extend to my other family members including minor children & pets who may also appear in that media. This media will be used for informational and promotional materials to be published & distributed via printed, digital & social media. I understand and agree that they will become the property of Once Upon a Tail Rescue, will not be returned, and that there will be no payment or any other type of consideration for their use. This authorization will continue indefinitely, unless I revoke such authorization in writing. I hereby hold harmless and release these entities and their respective employees, agents, representatives, volunteers, officers and directors from any and all claims, demands, damages, causes of action and liabilities of any kind, regardless of whether they are known or unknownn, that may arise during the use of these images.
If Once Upon a Tail deems it necessary to use an attorney to enforce the terms of this Agreement, Adopter shall be responsible for payment of attorney's fees, court costs, and/or fines necessary to enforce this Agreement.

I, the undersigned Adopter, have read and acknowledged the terms and conditions of this Agreement, have received an electronic copy of said Agreement, and acknowledge that I will also receive a copy all veterinary records available for the animal I have chosen to adopt.I agree to abide by all conditions listed within this Agreement.

Effective upon the date and time of this Contract, I, the Adopter, assume complete liability for the animal and release Once Upon a Tail Rescue and it's officers, directors & volunteers, from any and all claims, demands, damages, causes of action and liabilities of any kind, regardless of whether they are known or unknow, related to this pet.

I further hereby release PetSmart LLC and its parent entities, affiliates, and subsidiaries (collectively, "PetSmart") and PetSmart Charities, Inc. and PetSmart Charities of Canada (together, "PetSmart Charities"), and their respective employees, agents, representatives, officers and directors from any and all claims, demands, damages, causes of action and liabilities of any kind, regardless of whether they are known or unknown, related to the adoption of this pet. I agree that all costs and expenses incurred related to the adoption of this pet, including medical and adoption fees, are my responsibility and that I will not be reimbursed by PetSmart or PetSmart Charities.

I certify that the information provided on this application is complete, true and accurate to the best of my knowledge. I understand that providing false information may void this application and result in forfeiture of the adopted animal, as well as any adoption fees paid.

This Adoption Application becomes a legal and binding Adoption Contract on the effective date and time that the Adoption Fee Payment is accepted by Once Upon a Tail Rescue.

Signature*

Application Date*

Date

Application Time*

Hour Minutes

AM/PM Option

FINAL INSTRUCTIONS:

Please double check that you have completed all required fields and then click the SUBMIT button below. You will see a screen with a GREEN CHECK MARK when the application is submitted successfully. If the application is not submitting, please scroll up and complete any missing information in red, and try to submit again.

THANK YOU FOR YOUR SUPPORT OF OUR RESCUE AND THE DOGS WE DEDICATE OUR LIVES TO!