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COMPANION ANIMAL ADOPTION AGREEMENT CURRENT GUARDIAN INFORMATION: Name:_________________________________ Address:______________________________ City:_________________________________ State:________ Zip Code:______________ Phone Number:( )_______-__________ References Checked: Y/N Homecheck Completed: Y/N INFORMATION ABOUT ADOPTED ANIMAL: Cat/Dog/Other If other, specify: M/F Date of Birth: Color: Other description: Spayed/Neutered:Y/N ADOPTER'S AGREEMENT I,__________________________________ do hereby agree to the following terms and conditions upon adopting an animal from Dawne Ziegler. (If animal is not spayed/neutered at time of adoption) I agree that I will have the animal spayed/neutered at the appropriate time. The animal is being adopted for myself and will not be sold, adopted, or given to another party. The animal will not be allowed outdoors without proper supervision. When taking my cat/dog outdoors, they will be on a secure harness and wear proper ID. The animal is to be a companion animal, not a guard dog. The dog will live inside my home, not outdoors. I will care for the animal in a humane manner and be a responsible animal guardian. This includes supplying adequate food, water, shelter, attention, and medical care. If at any point I can not keep the animal, I will return him/her to the original guardian without requesting a fee.I understand and agree that the current guardian makes no guarantees about the animal's temperament and is not responsible for future damages or injuries caused by the animal.I give the current guardian the right to inspect my home or call my home at any reasonable time, without notice, to assure that the animal is being properly treated and cared for. I will keep the animal's former guardian informed of my current home address and phone number. I agree that all statements I have made on this form are true. If it is found that any statements I have made on this form are not true the adopted animal can be confiscated. Name:_______________________________ Address:____________________________ City:_______________________________ State:________ Zip Code:___________________________ Phone Number:( )______-_________ Driver's License Number:__________________________ License Plate:______________________________ Social Security Number:_______-_____-_______ Adopter's Signature:_______________________________________ Date:____/____/____ Current Guardian's Signature:__________________________________________________ Date:_______________ |