Headwaters Animal Shelter Adoption Contract
901 Western Avenue South
Park Rapids, MN 56470
TERMS AND CONDITIONS
web site: headwatersanimalshelter.org
Adopter Information Animal Information
___________________________________ H.A.S. NUMBER
Drivers License Number
____________________ ______ ________
City State Zip code If renting:
Home PH.# Cell/Work PH. # Landlord’s PH. # __________________________
___ I agree to provide this animal proper and sufficient food, water, adequate shelter, medical care
and kind treatment at all times.
___I agree to comply with all federal, state and local laws, regulations and ordinances applicable to
___I understand that adoption fees are NON-REFUNDABLE. If this animal fails to meet my
expectations I may return it to the Headwaters Animal Shelter within 7 days of the adoption date. I
will be issued a Replacement Certificate towards the adoption of another animal. The shelter
reserves the right to deny the issuance of a Replacement Certificate in situations that abuse/neglect
are suspected and/or the animal has died.
___I understand that animals can be unpredictable and that the Headwaters Animal Shelter cannot
anticipate or insure against unexpected conduct of any animal adopted from the shelter. I
acknowledge that the Headwaters Animal Shelter has not made through its agents, volunteers, or
employees any warranties regarding the future condition, temperament or conduct of this animal.
___I accept this animal “as is” and assume all risks and responsibilities associated with this
___I fully and completely to comply Headwaters Animal contract will result officers, volunteers,
a legal document. Failure release the with the terms of thisShelter, its directors,in legal action
agents, the adoptee, employees from the claim, will revert to the liability of Animal Shelter.
against servants, andand ownership of any animal cause of action orHeadwatersany sort or nature,
whether known or unknown, directly or indirectly arising out of or in connection with the adoption,
care, or ownership, maintenance, retention, temperament, conduct, or condition of this animal.
___I understand if I do not adhere to these terms, if I have misrepresented myself, or if I have
adopted this animal under false pretenses, the Headwaters Animal Shelter has the right to reclaim
___I have read and understand this contract and agree to its terms and conditions.
Signature of Adopter (must be 18 or older) Signature of H.A.S. Representative