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					7/29/2010 6:09 AM                                                                                          1



                                      Beaks and Noses Inc

                              Successful Placements and Adoptions




e-mail ellen@toydogrescue.org
Web page www.toydogrescue.org


DOG ADOPTION Contract
                                                       .
MY INITIALS NEXT TO EACH REQUIREMENT BELOW WILL SERVE TO SHOW THAT I ACKNOWLEDGE
               EACH STATEMENT AND AGREE TO THE TERMS OF THIS ADOPTION.
       I understand that I am not PURCHASING a pet but ADOPTING and SAVING THE LIFE of an
             orphaned pet and therefore there is NO TRIAL PERIOD and will be NO refund for ANY
          reason other than the pet being terminally ill (and this is confirmed by one of our vets). The
                          dog/puppy I am adopting will be left alone daily for _____ hours.
         I do hereby adopt this animal for MYSELF and MY FAMILY (not as a gift or companion for
            anyone OUTSIDE the home at the address below) and agree to take good care of it and
           protect it from abuse, neglect or abandonment and to keep the animal as a house pet and
               not allowed to run free, to provide proper medical care and to provide proper mental
            stimulation and love. I understand that my adoption is a LIFETIME commitment and I will
           NOT give up on my newly adopted pet for any reason - other than TERMINAL illnesses or
                     SEVERE aggression, which has been confirmed by a Licensed Vet and/or
                                  PROFESSIONAL TRAINER OR BEHAVIORIST.
            I am prepared to keep this pet for its entire life and I am prepared for all aspects of pet
          ownership both emotionally and financially($400-$1,000 yearly not including emergencies).
          HOWEVER, If I do choose to give up my pet, I MUST return it to the Beaks and Noses and
           not give it to anyone else, and I may be charged a surrender fee dependant on my reason
          for surrender, medical and vaccination history, length of time I have owned the pet, and the
          condition of the pet when I surrender him/her. I must also call the Beaks and Noses before
____                         returning the pet due to space and availability restrictions.
        By signing this contract I acknowledge that the entire family is in agreement of this adoption,
              that I am 21 years of age or older, that I own my own home or have written landlord’s
               permission and that there are NO PET ALLERGIES (that cannot be controlled with
          medication) in the home where the pet will reside. I also understand that I will not receive a
____                  refund IF I AM or MY family develops or has existing allergies to the pet.
       I understand that the Beaks and Noses CAN NOT & WILL NOT guarantee the health, breed,
          temperament or age of this pet and agree that I should never leave my pet unattended with
             children. Because I understand that my pet may need help in the transitional period and
            possibly even YEARS from my adoption date, I agree to work with a PROFESSIONAL&
           ACCREDITED trainer or behaviorist if the pet has or develops behavioral problems at the
____                                time of my adoption and/or the years coming.
        I am willing to give my pet an unlimited time to adjust to his/her new home and I understand
           that there may be behavioral issues with my new pet, such as hiding, shyness, not eating,
               growling, diarrhea, accidents, destructiveness and a variety of other issues . It is my
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           responsibility to follow the Beaks and Noses’s suggestions and do research on making my
         pet a better member of my family. Many of these important tips can be found in my adoption
                    literature pack and on their website http://beaksandnoses.toydogrescue.org
        I understand that though this pet may appear healthy at this time, it may in fact be in the 1st
         stages of an Upper Respiratory Infection/Kennel Cough, Skin problems, ear/eye Infection or
              Parasitic infection or have a variety of other medical problems - some of which may be
             contagious to other pets. It is recommended that I keep other pets away from the newly
          adopted pet until a complete check-up AND FECAL sample has been done for him/her and
          this is why the Beaks and Noses has advised me to obtain a physical for my newly adopted
             pet within 14 days of my adoption or 10 days post-op if surgery was performed. If the vet
            specified by the Beaks and Noses does this physical, it is at no cost to me.(All shots, test,
              and vaccines will still be at my own cost.) If I choose to take the animal to any other vet
___                                FOR ANY REASON it will be at MY OWN COST.
        This mandatory fee of $__275.00_____ will be applied towards general upkeep of the Beaks
           and Noses, vet care, other pets in the Beaks and Noses, food, heat, electric, phone, staff,
             and general expenses. (The Beaks and Noses runs strictly on adoption / surrender fees
          and these fees are what pay any and all bills incurred by the Beaks and Noses. The Beaks
               and Noses is NOT funded by state, town, city or government funds.) I understand the
           Beaks and Noses has done all that they can for my pet medically prior to him/her leaving. I
             am FULLY responsible for any and all medical bills incurred by my pet and I will NOT be
           refunded any money for any reason. It has also been recommended to me that I seek any
              medical care for my pet through participating Beaks and Noses vets who work with the
              Rescue animals at a lower cost. I also agree to have A FECAL SAMPLE run at the 1st
___        health check as this is crucial to uncovering any possible parasites that may harm my pet.
         I hereby agree that any default of these conditions by myself will immediately void all rights
           and interests I have gained in the animals and that I will turn it back over to the Beaks and
               Noses and should Beaks and Noses have to initiate any action, legal or otherwise, to
               regain such animal, I agree to indemnify and reimburse said Beaks and Noses for all
___           attorney’s fees and witness expenses including travel and loss of pay involved therein.
        If my new pet bites, I WILL BE RESPONSIBLE for the quarantine time OF 10 DAYS. I must
            also notify the Beaks and Noses, dog officer and/or my town’s Board of Health. If the pet
              bites or does any destructive damage to me or anyone else, from this date and time, I
            understand that is my responsibility and agree not to hold any person, employee, director,
___                               officer or volunteer of the Beaks and Noses, liable.


NOTE: Beaks and Noses Inc. has limited information on these animals and CANNOT and WILL
  NOT guarantee the health or temperament on these animals. Please understand Beaks and
Noses Inc. is dedicated to placing happy and healthy animals. Please make sure your decision is
not taken lightly and understand this is A LIFETIME COMMITMENT. We work hard to place these
                              unwanted animals into a home for life.


BEAKS AND NOSES INC. agrees to provide for the adoption of, and Adopter agrees to adopt the animal
described above ("Animal") according to the terms and conditions set forth herein:
The Animal you are adopting has been surrendered, abandoned, or in some way displaced. It may have
been abused or neglected. There may only be limited, if any, information available regarding the Animal's
previous environment. All available information and medical records have been provided to you. BEAKS AND
NOSES INC. does not guarantee, nor is it responsible for the temperament or health of this Animal, other
than as is separately set forth in this Contract. There will be an adjustment period. Remember to be patient,
consistent and understanding.
1. Adopter agrees to accept this Animal as a companion Animal to live in Adopter’s home. Adopter agrees to
   provide this Animal with proper food, water, veterinary care, and loving attention. Adopter agrees to
   provide Animal with adequate toys. Adopter agrees to provide Animal with appropriate exercise for his/her
   species. Adopter agrees to obtain pertinent information regarding the proper care of this
   Animal and to seek assistance from appropriate resources, including BEAKS AND NOSES INC.
   , as needed.
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2. Adopter understands that it is his/her responsibility to quarantine any adopted dog brought
   into his/her home for not less than ninety (30) days, or as is recommended by veterinarian.
3. Adopter shall allow BEAKS AND NOSES INC. the right to examine and make inquiry about
   this Animal at any reasonable time. Adopter shall return this Animal to BEAKS AND NOSES
   INC. if BEAKS AND NOSES INC. determines that this Animal is not receiving proper care.
4. Adopter agrees that, if at any time Adopter is unable to keep this Animal, Adopter shall
   contact BEAKS AND NOSES INC. for its sole determination as to the disposition of this
   Animal. Adoption fees are not refundable under any circumstances, except as provided in
   paragraph 2 of this Adoption Contract.
5. If the expense of medical care exceeds Adopter’s ability to provide appropriate and necessary
   treatment, Adopter agrees to contact BEAKS AND NOSES INC.                  immediately for a
   determination of available assistance from BEAKS AND NOSES INC. . Adopter understands
   BEAKS AND NOSES INC. may not have financial assistance available, but that BEAKS AND
   NOSES INC. shall make every effort to assist Adopter in making suitable arrangements in
   the best interest of the Animal.
6.Adopter promises to comply with the laws and ordinances enforced in the state and municipality
   in which Adopter resides.
 7. If for any reason in the future the adopter finds that he or she is unable to keep the
      Animal, and has give the Animal an honest try – the Animal will come back to beaks and
      noses
Beaks and Noses will not be responsible for any damage, biting or mishavior of any kind,

Adopter signature ____________________________ 7/29/2010 6:09:28 AM


CURRENT GUARDIAN INFORMATION:
NAME: ________Ellen Schloss________________________

ADDRESS: ____19 Fuller Rd______________________________

CITY: _____ _Billerica________________________________

STATE:__MA__

ZIP CODE: __01821_________

EMAIL:___beaksandnoses@toydogrescue.org_______
INFORMATION ABOUT ADOPTED ANIMAL:
CAT/DOG/OTHER
IF OTHER, SPECIFY: _____________

M/F
DATE OF BIRTH: __ _______Estimated Age _ ___
Color ______________________

OTHER DESCRIPTION: __ _
7/29/2010 6:09 AM                                                                     4


ADOPTER'S AGREEMENT
 I agree that the animal is being adopted for myself and will not be sold,
adopted, or given to another party. In addition, as of the date of this contract
any vet bills will be paid by the adopter and not Beaks and Noses Inc..
We can only guarantee, up to date on shots heart worm negative and altered. Unless
otherwise specified.
I agree that the animal will not be allowed outdoors without proper
supervision. When taking my dog outdoors, they will be on a secure harness
and wear proper ID.
I agree to care for the animal in a humane manner and be a responsible animal
guardian. This includes supplying adequate food, water, and medical
care.
I agree that if at any point I can not keep the animal, I will return him/her
to the original guardian without requesting or expecting a refund of your
donation, - this is for the protection of our dogs- We will replace the dog, with
a better suited dog for your lifestyle after the 30 day period only
It may not be in 1 or 2 days, but we will not forget you

I understand and agree that the current guardian makes no guarantees about the
animal's temperament or health, and is not responsible for future damages or
injuries caused by the animal. When the animal leaves Beaks and Noses the animal
is found to be altered, healthy and current on its shots, or if it has any physical
problems, you will know in advance. Unless as noted above!
I give the current guardian the right to inspect my home at any reasonable
time, without notice, to assure that the animal is being properly treated and
cared for.

I agree that all statements I have made on this form are true. If it is found
that any statements that I have made on this form are not true the adopted
animal can and will be confiscated

NAME:________ ____

ADDRESS:__          _____________

CITY:__________

STATE:_____
7/29/2010 6:09 AM                                   5



ZIP CODE:_______

PHONE NUMBER:_ ________

ADOPTER'S SIGNATURE
_________________________________________________

DATE: ____7/29/2010 6:09 AM_



CURRENT GUARDIAN'S SIGNATURE __




____                           _______

DATE: _____ 7/29/2010 6:09 AM_____________

				
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