Tyson’s Chance Animal Foundation Inc.
Pet you want to adopt_____________________________________________
Please list 2 personal references:
Do you live in a home_____condo______apartment_____other______
Do you own______rent____Landlords phone___________________________
Do you have a fenced yard? Y______N______
What kind of fence? _________________________________Height________
If not how do you plan to let out and exercise dog?
How many hours per day will dog be left alone?____________
Where will dog be kept while you are
Will dog be indoor___ outdoor___ or both____?
What is your main reason for adopting a dog?
How many people live in your household?_______________________________
How many children and what ages?____________________________________
Activity Level in your home is: Low______ Med_______ High_______
What other pets are in your household? (Please include breed and
Do you agree to allow a home visit prior to adoption? Y____N____
I certify that the above information is true and understand that false information will
result in nullifying this adoption. I also agree to return my adopted pet to Tyson’s
Chance and/or participating veterinarian as directed for any follow up visits or boosters
mentioned below. Only these listed procedures will be covered by the adoption fee.
Failure to do so by the dates listed below will void our financial responsibility for these
treatments. All other routine vetting will be up to date before adoption. I agree to return
my pet to Tyson’s Chance if for any reason I cannot keep them and understand that
transferring to another party without our approval goes against this written agreement.
I also release Shelburne Pet Center/ Tyson’s Chance Animal Foundation Inc. / East
Shelbyville Animal Clinic from any future vet bills, illness, or behavioral issues/events
that may arise after this contract is signed. I am committing to care for this animal and
will provide proper medical care, training, food, water, shelter, and grooming for my
adopted pet. I also agree to allow a Tyson’s Chance representative to do follow up visits
to check on the well being of my adopted pet if they feel necessary. I understand that if
the adopted animal is living in poor condition and not being properly cared for as
mentioned above, Tyson’s Chance has the right to reclaim this animal and will do so if
we feel our standards of care are not being met. This is to be determined by our
organization. I have read and understand this contract in full.
Tyson’s Chance reserves the right to refuse any adoption.
Please return your pet to Tyson’s Chance/ ESAC for:
Thank you for adopting from us and saving a life!