Document Sample
					                                                               STARFISH BORDER COLLIE RESCUE
                                                                    ADOPTION CONTRACT

Adopter’s Name:                                                                                          Breed:
Address:                                                                                                 Sex:                 Age:
Email Address:                                                                                           Color/Markings:
Phone Number:                                                                                            Date of last Vet check up:
Adopting Agent’s Name:                                                                                   DHLP:              Rabies:
Address:                                                                                                 Heartworm med:
Email Address:                                                                                           Next vaccinations needed:
Phone Number:                                                                                            Next Heartworm med needed:
Adoptive Dog’s Name:
I, __________________________________, attest to the facts stated in my submitted Adoption Application. I agree to adopt the dog described
above, now known as ______________.

The following terms and conditions constitute a legal contract for the adoption of the dog referred to above (hereinafter ref erred to as “dog”
regardless of age or sex) between Starfish Border Collie Rescue (hereinafter referred to as StarfishBCR) and _____________________________
(hereinafter referred to as adopter). These terms and conditions are entered into and agreed upon by both StarfishBCR and the adopter and
they acknowledge the legal worth of this contract.

To the best of StarfishBCR’s knowledge, this dog has no defects that would make it unsuitable as a family pet nor has t he dog bitten or injured
anyone. At the time of adoption all dogs are in good health; therefore, StarfishBCR cannot guarantee the health of the dog after the adoption
takes place.

Adopter agrees to all of the following terms of this contract and understands that non-compliance with the terms of this agreement gives the
adopting agent or their representatives the right to reclaim this dog without refund of adoption fee.

Please initial if in agreement:

      _____1.              To contribute an adoption donation in the amount of $_____. Donation is fully refundable if dog is returned to StarfishBCR
                           within 30 days for any reason.
      _____2.              To immediately license and place identification on the dog with tags and collar.
      _____3.              To abide by all laws and ordinances concerning this dog in the community in which I reside.
      _____4.              To provide shelter, fresh water, proper food and adequate companionship at all times.
      _____5.              To provide annual veterinary examination, monthly heartworm preventative, yearly stool samples, rabies according to my
                           state’s regulations, and vaccinations, monthly flea prevention medication and dental care as determined by my veterinarian.
      _____6.              To notify StarfishBCR immediately if this dog is lost, or stolen and to make every effort to locate the dog.
      _____7.              If for any reason adopter is unable to keep this dog, adopter will notify StarfishBCR immediately. At that time, StarfishBCR
                           will work with adopter to find an appropriate home for this dog without refund of adoption fee. Transfer of ownership of
                           this dog is strictly prohibited without prior written authorization of StarfishBCR.
      _____8.              To notify StarfishBCR if adopter moves and give the new email address, physical address and phone number.
      _____9.              The above dog will not be euthanized in a non-emergency situation without notifying StarfishBCR by registered letter and
                           giving 14 days to respond.
      _____10.             In the event of an emergency resulting in an evacuation from the house, area, or state by the owner s, this dog is to be
                           evacuated with said owners. No exceptions to this are allowed.
      _____11.             The adopter agrees to allow a StarfishBCR representative to periodically check on this dog to be assured of compliance with
                           items #1 through #10.

This Contract is binding and enforceable by Civil Law. Any breach of this contract in part or whole requires that the adopter voluntarily relinquish said dog and any papers that pertain to said
dog to StarfishBCR’s designated representative within five days of notification at the adopter’s expense without entitlement of any refund or damages of any kind.

Adopter promises and agrees to be solely responsible for this animal and to indemnify and hold harmless Starfish Collie Rescue, Mary Peterson, StarfishBCR Representatives and Volunteers
from any and all claims of liability for the conduct of this dog on or after the date of this adoption and agreement of contract.

The undersigned adopter has been advised of these facts and agrees to all conditions of this contract.

___________________________________________________                                             _________
Signature (Adopter)                                                                             Date

___________________________________________________                                             _________
Signature (Adopting Agent)                                                                      Date

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