You may copy and paste the updated agreement and email to dayna@allthewayhomeanimalrescue.com

 

 

 

All The Way Home Animal Rescue Adoption Agreement

 

                               Dayna J. Zizis Founder    631-766-1383             

 

 

 

 

Your Contact Information

 

First Name

 

Last Name

 

Your Age

 

Street Address

 

Address

 

Zip Code

 

Cell Phone Number

 

Other Phone Number

 

Email Address

 

 

More About You

 

Why do you want to adopt an animal?

 

 

Which kind of animal are you applying to adopt? Adoption fees below may be subject to change by All The Way Home Animal Rescue

 

 

Mixed Breed Dog - $150

Pure Breed Dog - $225

Mixed Breed Puppy -$300

Pure Breed Puppy - $400

 

Where will the animal primarily be kept?

 

 

Outdoor

Indoor - free roaming or confined to specific space

Indoor - crated

 

List below any pets you have owned in the last 5 years, how long you had the pet and whether or not you still have the pet. If not, where is it?

 

 

Are your current pets spayed, neutered and vaccinated? If not, why not?

 

 

Please provide the name, address and phone number of your veterinarian here. Under whose name are the vet records? Your vet will be contacted with your permission for a reference check.

 

 

 

Do you own or rent your home?

 

 

own

rent

 

Are you allowed to have pets?

 

 

yes

no

 

List all people living in the home and their ages.

 

 

Do you or anyone in the household have pet allergies?

 

 

yes

no

 

Please let us know how many hours the pet will be left alone each day and when alone, where will he or she be kept?

 

 

Please list your occupation, the name of your employer, address, name of your supervisor and phone number below:

 

Do you have a yard?

 

 

 

yes

no

 

If so, is it fenced in?

 

 

yes

no

 

If yes, how high?

 

 

Have you ever had to give up a pet? If so, please tell us why and where the pet went.

 

 

Do you have an area to quarantine the pet from other animals if necessary? 

 

 

yes

no

 

Can you describe any obedience training experience, or past personal experience with behavioral or medical issues?

 

 

Please provide All The Way Home Animal Rescue with three personal references with telephone numbers.  They will be contacted with your permission.

 

 

 

 

Are you willing to work through unexpected hardships with your pet, ie, housetraining, separation anxiety, fear, socialization, acclimation to other pets, etc?

 

 

yes

no

 

How do you anticipate rectifying these unforeseen  issues if they should  arise?

 

 

 

 

Adoption Contract and Affirmation

 

Do you agree that the animal is being adopted for yourself and will not be sold, adopted or given to another party?

 

 

yes

no

 

Do you agree that the animal will not be allowed outdoors without proper supervision?

 

When taking the animal outdoors, do you agree that he or she will be on secure harness and wear proper ID?

 

 

Yes

No

 

If adopting a dog, do you agree that this dog is to be a companion animal and not a guard dog?

 

 Do you agree that the animal will live inside your home, and not outdoors or in a business location?

 

 

Yes

No

 

Do you agree to care for the animal in a humane manner and to be a responsible animal guardian?

 

This includes supplying adequate food, water, shelter, attention and medical care. Including and not limited to heartworm prevention, Flea and tick prevention, Fecal exams,Yearly wellness exams, Spay or Neuter at your expense once adopted.

 

 

Yes

No

 

I agree that if at any point I cannot keep the animal, I will return him/her to All The Way Home Animal Rescue

 

 

I agree

I disagree

 

I understand and agree that All The Way Home Animal Rescue makes no guarantees about the animal's temperament, breed age or health and is

 

Not responsible for future damages or injuries caused by the animal. Once the pet is adopted all medical expenses are the responsibility of the new owner.

 

 

I agree

I disagree

 

I give All The Way Home Animal Rescue permission to call my home for follow up to assure that the animal is being properly treated and cared for.

 

 

I agree

I disagree

 

I agree to keep All The Way Home Animal Rescue informed of my current address and phone number.

 

 

I agree

I disagree

 

I, (name)

 

 

I am applying to adopt the following animal:

 

(Name of pet)

 

 

 

All animal adoption contracts approved by All The Way Home Animal Rescue are subject to the following terms and conditions:

The adopter agrees that the animal will be kept as a domesticated house pet.

 

This means that dogs are kept indoors except for periods of exercise in a fenced-in area or on a leash.

 

The adopter agrees that if the animal is not already spayed or neutered, the animal will be spayed or neutered within 14 days of the date on this contract dependant of age if under six months

 

and proof will be provided to All The Way Home Animal Rescue  within 2 weeks of procedure.

 

 

The adopter further agrees to provide proper veterinary care for the animal from the date of adoption for the entire duration of this pets life.

The adopter grants All The Way Home Animal Rescue the right to make periodic visits to the adopter's premises for the purpose of

 

 checking on the health and general welfare of the animal and to verify that the animal has been spayed or neutered in accordance with the terms of this agreement.

The adopter represents that all household members have agreed to the adoption of the animal and that all household members will abide by the terms of this agreement.

 

The adopter further represents that he/she is twenty one years of age or older.

The adopter represents that he/she has never been subject to legal action for cruelty to or neglect of animals.

 

The adopter further represents that he/she has never owned an animal which has been confiscated by an animal control officer or

 

humane organization for violations of state or local animal control regulations or animal adoption agreements.

If the adopter is a tenant, the adopter agrees to provide written permission containing contact information from the landlord consenting to the animal adoption.

If for any reason the adopter is unable to provide care to the animal, the adopter agrees to return the animal to All The Way Home Animal Rescue .

 

 The adopter shall not offer the animal for sale or give the animal to any third party without the prior written consent of All The Way Home Animal Rescue.

The adopter agrees that All The Way Home Animal Rescue shall have the right of immediate possession of the animal if,

 

in the judgment of ,All The Way Home Animal Rescue the animal is receiving inadequate care,

 

is being improperly housed or handled or has not been spayed or neutered by the specified date.

The adopter agrees to pay All The Way Home Animal Rescue  the sum of $1700.00 as liquidated damages in the event that the terms of this contract

 

 are breached; this liquidated damage value does not bar  All The Way Home Animal Rescue from seeking the return of the animal

 

by judicial process or other legal means if necessary. If legal action is instituted, the adopter agrees to pay all attorney's fees and court costs.

The adopter hereby declares that he/she is aware:

(a.) That animals are different from human beings in their responses to human actions;

(b.) That the actions of animals are often unpredictable.

(c.) That the animal's behavior may change after it leaves the shelter or other environment and accustoms itself to its new environment;

(d.) That All The Way Home Animal Rescue makes no claims as to the temperament, health or mental disposition breed age or size of any animal put up for adoption; we cannot promise breed or age of these pets as they were rescues and limited information is offered. All animals are rescued from high kill shelters and we are not provided with detailed information. We give it our best guess.

(e.) That the adopter herby accepts possession, legal guardianship and responsibility for the animal referenced in this contract and discharges

 

  All The Way Home Animal Rescue forever from liability for any injury or damage to any person or property caused in the future by said animal, and from any causes of action, claims, suits, or demands whatsoever that may arise as a result of such injury, illness or damages.

(f.) NO REFUNDS OF ADOPTION DONATION. No exceptions!

 

We do not hold pets for adoption unless 50% of the donation is received. We only can hold for a 48 hour period. If signer of this contract does not claim pet within this period of time or backs out of adoption, this donation will not be refunded.

 

(g.) That the adopter has read and printed  a copy of  All The Way Home Animal Rescue Adoption Contract Terms (Please print for your records).

 

(h.) All adoptions will come with a wellness exam provided by our vet that MUST be attended within 5 days of adoption. Owner will provide proof of visit.

 

If prior appointment is made by All The Way Home Animal rescue and is cancelled, No show, or not attended, the signer of this contract will be billed for the missed exam. 48 hour notice prior to cancellation or reschedule is needed or the signer of this contract will be billed by our vet and held responsible.

I hereby declare that I am the adopter whose name is affixed below, and all of the information I have provided is true and complete to the best of my knowledge.

 

 

Agree

Disagree   Applications will not be accepted without signature.

 

By providing your signature, you are complying to and in agreement of all aspects of this contract and adoption agreement.

 

Signature (typing in this box acts as your legal signature)  Date._________________