| ADOPTION APPLICATION (Labrador Retriever Rescue of Middle Tennessee) Applicant Name: ________________________________________________________ Physical Address:________________________________________________________ City:_____________________________________ State:___________ Zip:_________ Home Phone: ________________________ Work Phone:______________________ E-mail: ________________________________________________________________ Please list the any pets, their species, breed, age and sex that you currently own at this time: Species Breed Age Sex Cat/dog/bird/fish Neutered/spayed/intact. _______________ ____________ _________ __________________ _______________ ____________ _________ __________________ _______________ ____________ _________ __________________ If you do not currently own any pets at this time but have in the past, please tell us about those pet(s). Are you married or single, have children? If so, what are their ages? Do you currently have a veterinarian? Please give us his or her name and practice name. Do you own or rent your home? If you rent, can you furnish us with landlord proof that you are allowed to have a pet over 60 pounds? How do you plan to contain the dog to your property? Fenced yard, daily walks on leash, off leash�please explain? Are you willing to enroll in a basic obedience class if needed? Are you willing to crate train the dog if necessary? Are you able to provide between $800.00 and $1500.00 per year for the regular care and up keep to own a dog? What type of activity level do you expect from a Labrador Retriever? Highly Active__ Moderately Active__ Low key__ Very laid back__ How have you educated yourself about the Labrador Breed? (Books, AKC, acquainted with other labs, etc. Please explain) PREFERECES (Please indicate your choices below and if flexible, indicate the choices with #1, #2, etc.) COLOR: Black___ Chocolate___ Yellow___ SEX: Male___ Female___ AGE RANGE: _________________________________ ____________________________________________ ________________________ Applicant(s) signature Date ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ ADOPTION AGREEMENT (LABRADOR RETRIEVER RESCUE OF MIDDLE TENNESSEE) This agreement made between the parties of _______________________________ hereinafter referred to as the adopter and Labrador Retriever Rescue of Middle Tennessee, hereinafter referred to as LRRMT. This agreement is entered on this day _____________of __________, 2002. This adoption is for the following described Labrador Retriever: Sex:_____ Color and/or markings_________________ Name_________________ Permanent Identification:___________________________________________ A). The adopter agrees to pay a $150.00 non-refundable adoption fee to LRRMT. The adopter understands that the dog may be returned to rescue at any time for any reason but the adoption fee will be retained to help cover some of the cost associated with the care of all rescued Labradors under LRRMT management. B). The adopter agrees to provide this dog with annual preventative veterinary care such as regular inoculations for communicable diseases including rabies. The adopter also agrees to provide monthly heartworm prevention and any other medical care as needed. C). The adopter agrees to never chain this dog or allow the dog to roam freely. D). If the adopter is ever committed by a court of animal cruelty, the dog shall be returned to LRRMT immediately. E). LRRMT cannot warranty this dog in any way against health or temperament. LRRMT makes every effort to evaluate a dog in temperament prior to placing such dog with the adopter. Any medical conditions that are known or have previously occurred will be acknowledged to the adopter. The adopter agrees not to hold LRRMT or its volunteers responsible or liable for any damages or monetary expenses occurred as a result of this dog�s temperament and/or health. F). If this dog is ever returned to LRRMT, no adoption fees or any portion thereof will be refunded. LRRMT will make every effort to re-home the dog, however LRRMY does not disclose adoptee personal information to previous adopters. G): LRRMT has the right to reclaim this dog if the owner has been found to be neglectful and/or in breach of this agreement. I______________________________________have read the above agreement and agree to abide with all conditions A-G set forth above. ________________________________ __________________ Signature (Adopter) Date ________________________________ __________________ Signature LRRMT Representative Date RETURN TO: LRRMT Teresa Gordy 190 Sutton Lane Ashland City TN 37015 |
| Please print the forms below and once completed return to LRRCT. |