Hedgehog Adoption Application form

How did you hear about Miami Hedgehog Rescue?
Full Name*

First NameLast Name
Date

MonthDayYear
Date
E-mail*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Are you over the age of 18?

YesNO

Living Situation
Do you:

OwnRentLive with othersOther
If Renting: Please include landlord contact information.
Does Anyone in your household have allergies to Animals?

YesNo
Are all members of your family agreeable to adopting a Hedgehog?

YesNo
Please describe your ideal hedgehog (Gender, color, temperamnet, age, etc.)

Do you currently own a hedgehog?
If yes what's their gender?
Have you done thorough research in proper hedgehog care?
Who will be the main caretaker of the hedgehog?
Have you had any experience with with a hedgehog or other exotic pets?

YesNo
If Yes please explain
Will this hedgehog be used for breeding purposes?
Please describe any other animals you have in the house and how many.
Briefly describe the enclosure you intend on housing your hedgehog in. Type of cage, bedding, type of wheel.
Hedgehog you are interested in? Please include the name, color, gender of hedgehog you prefer.

Who's your Exotic Vet?

Not all vets treat exotic animals, so please check with your vet to ensure they will treat your new hedgehog.
Vet Reference: Full Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
Please list 3 references. Include name, phone number and email address.

By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully.

I attest that I am over the age of 18 years old and I am adopting this hedgehog for myself.

I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the forfeiture of any hold placed on a hedgehog and I will not be eligeable to apply for adoption any time in the future.

I certify that the above information is correct, and I understand that the information will be verified.

I understand that by submitting this form electronically, I agree to release and to hold harmless Miami Hedgehog Rescue and it's members from any claims, damages, costs, or actions incurred because of the care or actions of the hedgehog.

I accept full responsibility for the hedgehog(s) actions at all times, and release Miami Hedgehog Rescue from any liabilities or damages that may be incurred.

I agree that if I can no longer care for my hedgehog, he/she will be voluntarily surrenderred back to Miami Hedgehog Rescue.

I agree that I have READ and understand Miami Hedgehog Rescue's policies and agree with them.
Date*

MonthDayYear
Your name*
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