Hedgehog Adoption Application form

How did you hear about Goldenheart Hedgehogs
Full Name*

First NameLast Name
E-mail
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Phone Number

Area CodePhone Number
What kind of hedgehog are you interested in?

Baby HedgehogAdult HedgehogSpecific Hedgehog: specify belowOther

Living Situation
Do you:

OwnRentLive with ParentsOther
Does Anyone in your Household have Allergies to Animals?

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

YesNo

Care For?
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?

YesNo
Briefly describe the enclosure you intend on housing your hedgehog in. Type of cage, bedding, type of wheel.

Who's your 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

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

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

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 covenant to hold harmless Goldenheart Hedgehogs 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 Goldenheart hedgehogs from any liabilities or damages that may be incurred.
Date*

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Your name*
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