MMFM Adoption/Rehoming Contract & Waiver Form

Adoption & Foster Application

Potential Dog Parent*

First NameLast Name

Name of Pet & Breed You Wish to Adopt*

Your Age*

Your Drivers License # & State Issued In*

Date Of Birth MM/DD/YEAR*

Email Address*

Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Employer Name*

Years of Employment with this Employer*

Employer Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Employer Phone #*

Area CodePhone Number

Co Applicant

First NameLast Name

Relationship To Applicant

Co Applicant Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Co Applicant Phone #

Area CodePhone Number

Co Applicant Drivers License # & State Issued In

Co Applicant Age

If there are other's living in household besides yourself, please list names & ages of all members in household*

Why do you want to own a dog?*

Have you ever Adopted, Rescued, or Fostered A Dog Before? If so, please give Rescue Information*

Do you own a dog now? If so, what type of breed, age,sex and spayed / neutered. Please include past dogs as well *

Pet Name(s)*

Please describe your dog's disposition and behavior towards other dogs?*

Do you have a cat in your home? If so, gender, age,breed and altered?*

Any other pets in your home?*

If you do not have any pets in your home, will dog have access to other dogs for socialization? If yes, please explain*

Please provide your veterinarian's name, address and phone number: Please let your vet know that we will be calling and please give permission for them to speak with a member of MMFM*

Do you own or rent your home?*

OwnRent

Do you have a yard?*

YesNo

If "Yes" to the above, is it fenced? please describe

What is your landlord's pet policy?*

If you rent, please provide your landlord's phone#, address here:*

If your landlord approves for you to have a dog, we will need approval in writing from your landlord. *

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

YesNo

Are there children in your home? *

If you answered "Yes" to the above question, please provide ages of all children in home

If there are no children in your home, will the dog have access to children under the age of 10? If so, what ages?

Do any members of your household have allergies or asthma?*

Are you aware that dogs shed all year long?*

Who will care for, excercise and train dog?

Have you ever sold, given away, surrendered or had a dog euthanized? If yes, explain and provide the vet name,address & phone#. Please give them permission to speak with a member of MMFM*

Will the dog be walked daily? If not, how do you plan to excercise the dog?*

Will you provide annual visits to the vet for the dog?*

Will the dog attend formal obedience training? *

How many hours per day would the dog be alone?*

Will the dog be crated? If so, how long of period at a timet?*

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

If you move, what will you do with the dog/any other pets you may have?*

If you move and do take the dog with you, you will be required to notify MMFM in writing 30 days prior to your moving.*

A member of the MMFM will request a home visit prior to adoption. Do we have your approval?*

Are you aware of and do you understand the state/local ordinances in your area concerning dog licensing?*

Have you or anyone in your household been cited for licnsing or leash law violation/s?*

Will the dog be allowed on your furniture?*

Where will the dog eat/sleep?*

Will the dog be allowed free run of your house?*

Are you familiar with the use of a dog crate to train and/or confine the dog during absences or at night?*

Are you aware that the average cost of maintaining a dog can be $1000.00 or more a year? (Food, annual check ups & shots, heartworm & flea/tick prevention, grooming*

How would you deal with behavioral issues such as barking, chewing, destructive behavior, bathroom accidents indoors, unruly leash behaviors in your pet?*

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

YesNo

If you answered "Yes" please provide a detailed description:

You will need to provide MMFM with 3 references. Cannot be family members. Please provide Name, Address, Phone #'s and how long have you known reference. Please let them know that a member of MMFM will be calling*

Are you willing to give the dog at least one (1) month to ensure proper adjustment time?*

Are you aware that there is a adoption fee of $400.00 that must be paid prior to finalizing the adoption/rehoming?*

By clicking the submit button, I agree to Moving Mountains For Mastiffs adoption process, will undergo a homecheck, and phone/person interview with a member of Moving Mountains For Mastiffs.
By clicking the submit button, I understand Moving Mountains For Mastiffs will check my references including veterinary and personal.
By clicking the submit button, I understand there is an adoption donation associated with adoption of a pet from Moving Mountains For Mastiffs and that it is tax deductible according to IRS 501(c)3 guidelines. I understand this donation will ensure the organization is equipped to rescue another homeless pet.
By clicking the submit button, 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 Moving Mountains For Mastiffs BY EMAIL and provide a 14 day period to allow Moving Mountains For Mastiffs to make arrangements for my pet to be taken back into rescue or when possible sooner than 14 days. Amount of time to be delegated by Moving Mountains For Mastiffs.
By clicking the submit button, I agree to indemnify and hold harmless Moving Mountains For Mastiffs 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 clicking the submit button, I understand that Moving Mountains For Mastiffs will disclose any of the pet's health or behavior issues that are known before adoption is completed.
By clicking the submit button, I understand that if I no longer want my pet, or am no longer able to care for my adopted pet, or pet needs to be euthanized (other than old age) I will be directed to surrender my pet to Moving Mountains For Mastiffs (per guidelines stated above) and will provide transport to where Moving Mountains For Mastiffs deems appropriate at my own cost.
By clicking the submit button, I verify all of the above information is true and accurate.

I understand that by electronic signing, this is the same as a written signature and all of the above will still apply.

Please allow 7-10 business days for your application to be processed.

Signature