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Central Ohio Samoyed Rescue

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Central Ohio Samoyed Rescue Powered By Docstoc
					(Your Rescue Program Name Here)
RELEASE AND INDEMNITY AGREEMENT IN CONSIDERATION of the payment of _____________________________________________ ($ _______________) dollars, the receipt of which is hereby acknowledged Adopter(s) do hereby release, discharge and hold harmless (your program name here), hereafter "(your program acronym here)", and any other person, firm or corporation charged or chargeable with liability, their heirs, administrators, executors, successors and assigns, from any and all claims, damages, costs, expenses, loss of services, actions and causes of action belonging to the said Adopter(s) arising out of any act or occurrence from the present time, and particularly on account of the adoption of _____________. The Adopter(s) hereby declare that no representations about the nature of said dog, nor any representations regarding the nature and extent of legal liability of financial responsibility have induced the Adopter(s) to make this Release and Indemnity Agreement. THE UNDERSIGNED hereby further agrees to abide by the "Terms of Release" listed below: 1. TATTOOING - If not already complied with, the dog must be tattooed within 14 days from the date of this agreement. Adopter(s) must give proof of the tattooed number to (your acronym here). The dog's tattoo number will be registered with a National Dog Registry. IDENTIFICATION - The dog must be licensed in accordance with the laws of the jurisdiction in which the Adopter(s) reside. LOSS - If the dog is lost or stolen, Adopter(s) will notify (your acronym here) immediately. Failure to adhere to this rule will result in forfeit of ownership, if the dog is returned to (your acroymn here). HEALTH PROGRAM - The dog will be given an ANNUAL heartworm check and maintained on a quality preventative, and a program established by the Adopter(s) veterinarian for the rest of the dog's natural life. The Adopter(s) will provide high quality dog food, water, shelter, protection and any medical care needed. The Adopter(s) understand that the dog will be up to date on all vaccinations; however, accept the risk of the dog previously contracting rabies and hereby releases (your acronym here) of any liability or results thereof. TRAINING - Under no circumstances will the dog be dual personality, protection, or attack trained, or agitated in any manner, or be allowed to be used or trained as a guard dog for any agency, firm, corporation or organization. ___________ (Initial) RESPONSIBILITY - The Adopter(s) understands that (your acronym here) cannot be responsible for the behavior of this dog after adoption and the Adopter(s) accept full legal, custodial and financial responsibility for the dogs actions. RESERVATION OF RIGHTS - (your acronym here) reserves the right to follow through on this adoption in order to protect the welfare of the dog. If the Terms and Conditions of this Agreement are not upheld by the Adopter(s), and/or if any misrepresentations have been made to (your acronym here) by said Adopter(s), (your acronym here) reserves the right to

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terminate this Agreement and (your acronym here) may reclaim the dog immediately, without notice, from the Adopter(s) home or premises.

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ATTORNEY FEES AND COSTS - Should it become necessary for (your acronym here) to take legal action to recover an adopted dog or otherwise enforce the provisions of this Agreement, the Undersigned Adopter(s) agree(s) to pay all court costs and reasonable attorney's fees. The place of venue shall be (your county and state). ___________ (Initial)

THE UNDERSIGNED understands that the parties hereby released admit no liability of any sort by reason of the said adoption and that said payment (if any) is made to terminate further controversy respecting any and all claims for damages that said Adopter(s) have heretofore asserted or might personally or through personal representatives hereafter assert because of said adoption. BY SIGNING THIS CONTRACT, I AGREE TO ALLOW (your acronym here) TO ENTER MY PROPERTY FOR THE PURPOSE OF REMOVING THIS DOG FROM MY CUSTODY IF I DO NOT COMPLY WITH THE ABOVE TERMS. I have read and received a copy of, and hereby agree to abide by, ALL THE TERMS AND CONDITIONS of this Agreement.

SIGNED this _____________ day of ________________________, 19____

______________________________________ Printed Name of Adopter _____________________________________ Signature of Adopter

_________________________________ Drivers License Number (required) _________________________________ Phone Number (required)

_____________________________________ Printed Name of Adopter _____________________________________ Signature of Adopter

_________________________________ Drivers License Number (required) _________________________________ Phone Number (required)

_____________________________________________________ Address _____________________________________________________ City, State and Zip Code

_______________________________________ Agent for (your rescue program name)

_______________________________________ Witness


				
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