O
PLEASE,
PLEASE DO NOT USE ANY
HARTZ BRAND OR BIO-SPOT FLEA/TICK or FEED PRODUCTS
OF ANY KIND ON YOUR PETS.
THESE PRODUCTS KILL!!!!
MORE INFO CAN BE FOUND AT www.hartzvictims.org
Adoption Application for Ruff Life Rescue
Please understand that the thorough nature of this application is for the COMPLETE BENEFIT of the ANIMAL being adopted. We are seeking the BEST possible home for this rescued pet!
Please be prepared to provide proof of residency, drivers license and mortgage statement/rental lease upon time of adoption.
Adopters Information
Name:
__________________________________________________________________________
Age: _________________ Drivers License #:________________________________
Email:_____________________________________________________________________
Address:___________________________________________________________________
_____________________________________________________________________________
Work#:______________________________________________________
Home#: _____________________________________________________________
Cell#:____________________________________Fax:________________________
Occupation:___________________________________
Employer:_______________________________________
· What hours do you work: ______________________________________________________________
· Are you a Home owner or Renter? : ____________________________________
· Landlords contact info(if applicable):________________________________
Do you have a secure play area?___________fenced yard?__________________
Who will be the primary caretaker of this pet? ____________________________________________________________________
Who will be financially responsible for this pet (food, vet visits,etc.)?_____________________________________________________________
Pet Information:
Which animal are you inquiring about? __________________________________
Have you ever had this type (species or breed) of pet before or have you had experience with this type of pet?_____________________________________
If this pet is not available or is found to be unsuitable for your household, would you be interested in meeting another recommended by our adoption counselor?_____________________________________________
What breed/sex/age of pet would you be interested in? ____________________________________________________________________________________________________________________________________________________________
(1)
Household Information
· Names of people living with you. Please include ages of minors under the age of 18.
__Name______________Age______________________Relation_______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Was a vet other than your current vet used for the pets below ? If so, please list their contact information next to the pets name.
Previous Pets: Reason they are no longer owned: Vet:
_______________ _________________________________________ _________________
_______________ _________________________________________ _________________
_______________ _________________________________________ _________________
_______________ _________________________________________ _________________
Current pets in home:
name breed / age Vet:
______________ __________________________________________ _______________
______________ __________________________________________ _______________
______________ __________________________________________ _______________
* are your current pets UTD on vaccines and spayed/neutered? ____________________________________________________________________________
* we require all current pets be spayed or neutered before adoption of new pet. Is this a problem?_______________
If so, please state WHY: __________________________________________________________________
· How much playtime/exercise do you devote to your current pets on a daily basis?________________________________________________________________
· Please describe the set up / area that you will be providing for this newly adopted pet:
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
*will this animal be kept indoors except for exercise or play? _________________
* We do NOT allow OUTSIDE kenneling/tie outs: agree? _____________
* Do you agree to a home visit prior to adoption? ______________________
*Do you agree to a home visit 30 days post adoption? __________________
* Do you agree to a meeting w/ current pets and all family members? _____________
* Do you agree to have this pet altered within the time specified by rescue contract? ________
( a vet visit will be scheduled by intake worker, unless other arrangements are agreed upon and written in adoption contract)
· If, two years from now, you are planning to move, what will happen to this pet?_____________________________________________________________________
(2)
· Do you have any questions regarding this particular pet or its care in general?__________________________________________________________________________________________________________________________________________________
*Do you agree to complete and honor a legally binding adoption agreement? (please see below) ______________________________________________________________________________
REFERENCES:
Three (3) Personal References:
Please list references that have been to your home and that you have known for at least 3 years. We require that you list at least one reference that is NOT a member of your family.
name, contact #,Years Known, relation to you: __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Veterinary reference: If you do not have one already, please list who you will be using.
____________________________________________________________________________
name/phone
Are you currently meeting or inquiring about another pet in different rescue,shelter or other source? _________
IF so, what is the status? __________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
I understand that applications and Pre-adoption contracts will go through a thorough screening process to assure that the animal in question is being placed in the appropriate home. No guarantee of adoption is possible until application has been processed, approved and had a successful meeting with the available pet.
________________________________________ ________________
Signature Date
Please review the following contract. This is an example of the lifetime lease for Ruff Life Rescue. Please do not fill out the form below until the time of adoption. Please address any questions/concerns with the contract below at this time.
Thank you for your interest in adopting a rescued pet!
(3)
Ruff Life Rescue Adoption Policy, Standards and contract
Adoption fees are utilized to continue the rescues mission of saving abandoned pets. Adoption fees are NON-Refundable EXCEPT:
Spay/Neuter Policy: Pet must be altered within limits stated on the Lifetime Lease. Proof of alter MUST be provided to Rescue when surgery is completed. Any contract not honored will result in Rescue reclaiming pet. our adoption counselor will provide local resources for low cost spay/neuter program information and rabies clinics.
Health Policy:
Our veterinarians and staff evaluate each rescued pet for all general health issues that are apparent prior to adoption. If a pet becomes ill w/in the first 7 days post adoption, in order for Ruff Life to accept any responsibility for costs incurred, Adopter MUST call rescue and return rescued pet to Ruff Life Rescue for treatment by our approved veterinarian. Pet will then be returned to adopter when health is cleared by vet. If health issue cannot be remedied within 7 days, a refund or exchange will be offered.
We ask that you give a minimum of 30 days to any adopted animal to adjust to your home environment. In the event, you decide this is not the proper fit for your lifestyle or the pet, The adopted pet MUST be returned to the rescue immediately and not re-homed to outside sources. We ask that you notify the rescue and allow a minimum of 7 days for rescue to reclaim the adopted animal.
*********************************************************************************************
I agree to all terms and conditions of the adoption contract through Ruff Life Rescues Adoption and Foster Care program.
I understand that these are rescued shelter animals and their history and future is unknown. Adopting Rescue can make no guarantees as to temperament, health or behavior. A thorough health and temperament assessment has been completed by qualified staff, but implies no guarantees to future behavior. Animals will need time and patience during their adjustment period to your home. Animals may not be housebroken or trained in anyway.
Adopting Rescue or associate is not responsible for any injury or damage that adopted animal may cause to home, property or pets/person(s).
I understand that applications and Pre-adoption contracts will go through a thorough screening process to assure that the animal in question is being placed in the appropriate home. No guarantee of adoption is possible until application has been processed and approved.
________________________________________ ________________
Signature Date
Contract of Lifetime Lease For Ruff-Life Rescue
Adopters Name:___________________________________________________________
Phone #:______________________________Cell#: _____________________________
Address:___________________________________________________________________
Email: ______________________________________________________________________
*********************************************************************************************
Known to All Persons:
That the ______________________________________________________________(color,sex,age,breed)
known as ________________________________________________________________________ be
transferred From Ruff Life Rescue Club to
__________________________________________________________(name of adopter)
with the following conditions.
Please initial to indicate you agree:
1.________ Both parties ( adopter and rescue) agree that this is a legal and binding contract and do agree and affirm to abide by its
contents by their signatures below.
2.__________ That adopted pet be housed with the adoptive family at the above address and that adopter will not give,trade,lend or trade said animal for any reason.
3.______Adopted pet shall receive all mandatory vaccines yearly from their veterinarian. Also in the event of illness or injury the adopter agrees to seek medical attention in a reasonable amount of time.
4.________It is agreed that adopted animal will be taken to a vet within 10 days of adoption for a basic exam and any necessary medical care documented on health record and forwarded to adopting rescue.
5.____________ It is agreed that adopter will have the adopted animal spayed or neutered within 90 Days of adoption (when applicable).
6. ____________ It is agreed that I will provide proof of neuter/spay within the agreed timeframe set by adoption contract. If I do not provide this proof, Pet will be reclaimed by rescue. I have been informed of low cost programs in my area.Proof must be mailed to rescue.
7._________Adopter agrees to notify RESCUE in the event of an address change or death of pet. (A vets office will confirm a death over the phone w/owners consent)
8.________Adopter agrees to return adopted pet to rescue in the event of a life change where the animal could no longer be kept.
9.__________ That adopted pet will be Quality Brand dog food and fed 2x's a day and receive clean water on a daily basis.
10.__________I agree not to use any HARTZ,SAERGENTS, BIO-SPOT Products on my adopted pet. Please visit www.hartzvictims.org for more information.
11.____________ I understand that these are rescued shelter animals and their history is unknown. Adopting Rescue can make no guarantees as to temperament, health or behavior. A thorough health and temperament assessment has been completed, but implies no guarantees to future behavior.
12.___________ I agree to have my pet licensed according to my counties policy with in 30 days of adoption or by 4 months of age (if puppy adoption).Proof must be mailed to rescue.
13. __________I agree to keep my pet on monthly heartworm & flea/tick preventative as recommended by my veterinarian.
14.__________ I have been informed of the benefits of formal dog training and it’s importance in living a happy life with my new pet, although it is not required by rescue. I have been given recommendations of local programs.
15._________ I agree that Rescue may contact us in the future to check on the status and well-being of the adopted pet via telephone, email or a scheduled home visit.
16.________ It is agreed that rescue and/or affiliates is NOT responsible for any damage or injury caused by adopted animal to home, property, persons or pets.
17.________I understand that if Rescue is notified of any neglect or abuse of our rescued pet that we may reclaim the pet immediately with no legal consequences.
We would like to be included in quarterly newsletters _____Yes _____No
I understand the above contract and have agreed to abide by the adoption standard of Ruff Life Rescue. I have addressed any concerns about the adoption policy that I may have and any questions or concerns that I may have about caring for my new pet.
________________________________________________________________________
Signature of Responsible party Date
_________________________________________________________________________
Rescue Representative Date