Jess In Time Rescue Adoption form

Adoption Application, Contract and Waiver

Prospective Pet Parent

First NameLast Name

Name of Pet You Wish to Adopt

Phone Number

Area CodePhone Number

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Do you own any pets?

Pet Name(s)

Pet Breed(s)

Pet's disposition and behavior towards other cats?

Please provide your veterinarian's name and phone number:

Do you own or rent your home?

What is your landlord's pet policy? (Renters only need answer)

If you rent, please provide your landlord's information here:

Have you ever surrendered a pet you own to any animal shelter including a "low" or "no kill" shelter?

Are there children in the home? (If yes, please list ages)

If you answered "Yes" to the above question, please provide detail:

If you have to leave town, emergently or planned, where would your pet stay?

Please provide the names, emails, and contact numbers for 2 personal references:

Have you ever been convicted of an animal related crime, such as cruelty to animals, animal theft, or animal abandonment?

By signing this form, I agree to Jess In Time Rescue adoption process, will undergo a homecheck, and interview at the discretion of Jess In Time Rescue.
By signing this form, I understand that Jess In Time Rescue will check my references including veterinary and personal.
By signing this form, I understand there is no "cooling off" period, and that if I no longer want or can no longer care for my adopted pet, I agree to notify Jess In Time Rescue and provide a 14 day period to allow Jess In Time Rescue to make arrangents for my pet to be taken back into rescue.
By signing this form, I agree to indemnify and hold harmless Jess In Time Rescue, against any losses, lawsuits, claims, injury, damages incurred by me or to any persons or property by my adopted pet, once adoption has been completed.
By signing this form, I understand that Jess In Time Rescue. will disclose any of the pet's health or behavior issues known by the above named rescue group before adoption is completed.
By signing this form, I understand that if I no longer want my pet, or am no longer able to care for my adopted pet, I will be directed to surrender my pet to Jess In Time Rescue and provide transport to where Jess In Time Rescue deems appropriate.
By signing this form, I agree to spay/neuter my pet before they reach 6 months of age.
By signing this form, I verify all of the above information is true and accurate.

Signature of Potential Pet Parent