PGBV Lifeline, Rescue, and the undersigned person (the "Adopter/you") in consideration of the mutual promises in this Agreement and other good and valuable consideration, intending to be legally bound by this agreement, agree to the following terms and conditions: 1. The Dog. We are placing the following Petit Basset Griffon Vendeen dog/puppy (the "Dog") with you, the Adopter. Name: __________________________________________________ Male ____ Female ____ Date of Birth: ___________________________ AKC reg# (if known) _______________________ Color/Markings: _________________________________________ Weight ________________ ID Type: Microchip ____________________________ Tattoo: ___________________________ Spayed ___ Neutered ___ Unaltered (medical necessity) ___ Reason: ____________________ Unaltered - Sterilization Agreement Deadline: _________________________________________ 2. Adoption Donation. We require an adoption donation for the dog to help defray our expenses for the Dog's expenses and veterinary care. We have a very limited budget. If the dog is not a good match for your family and is returned within three (3) weeks from the date of adoption, the adoption donation less $20 will be refunded. Our adoption donation, including case-by-case donation determination, is detailed on our web page (http://www.geocities.com/pbgvlifeline). By signing this contract you are agreeing to this ________ donation. 3. No Representations. This Dog was previously unwanted, lost, or abandoned and may have been rescued by us from a dangerous, unhealthy or cruel situation. This could have long-lasting effects on the Dog. You agree that we are making no representations or warranties about the health, condition, personality or temperament of the Dog. 4. Care of the Dog. You agree to provide the dog with a lifelong caring home, wholesome dog food, fresh water, indoor sleeping quarters, and adequate outdoor exercise. You will treat the Dog as a household pet, comparnion and family member. You agree to abide by the dog laws in force for your municipality/state. You agree to never allow the Dog to ride in an open uncovered vehicle (i.e., the bed of a pickup truck, convertible, etc.). You further agree not to allow the Dog to exercise off-leash outside of your securely fenced yard or a fully supervised and securely fenced community dog park. You agree never to breed the Dog or use it for dog fighting or other "sport" in which one animal is pitted against another with physical contact. You also agree never to beat or taunt the Dog in order to promote aggressive behaviors. You agree never to abuse the dog physically or emotionally by the withholding of food, water, nurturing companionship or veterinary care. 5. Veterinary Care. You agree to have the dog examined by a licensed veterinarion within ten (10) days of placement and not less than yearly thereafter. You agree to consult with a veterinarian for appropriate vaccination schedules, heartworm preventative and other required treatment. In case of illness or injury, you agree to seek immediate veterinary care. 6. Transfer of Dog-Return to Rescue. In the event you are unable to keep the Dog, you agree to notify PBGV Lifeline either by mail or by phone to make arrangements to return the Dog to PBGV Lifeline. You agree that you will pay all expenses for shipping and/or transporting the Dog to the PBGV Lifeline representative nearest you who is able to accept the dog back for foster care. You agree never to give away, abandon, auction, sell or dispose of the Dog in any way. 7. Euthanasia. You agree that you may not euthanize the Dog except in the case of the Dog's terminal illness or injury, or debilitating effects of old age accompanied by pain and suffering. Euthanasia must be performed by a licensed veterinarian and you will notify PBGV Lifeline of the euthanasia. 8. Lost Dog. If the Dog becomes lost, you agree to make every effort to find it by (a) immediately filing lost dog reports with the local police, animal control authorities, animal shelters, and local veterinatrians; (b) immediately notifying PBGV Lifeline (email: [email protected], website lost dog report http://www.geocities.com/pbgvlifeline); (c) posting lost dog signs, and (d) placing an ad in the newspaper. 9. Breach of Contract/Liquidated Damages: PBGV Lifeline reserves the right to follow up on this adoption in order to protect the welfare of the Dog. In the event you do not comply with the terms of this contract, or the Spay/Neuter Agreement if applicable, or if the Dog is abused or neglected while in your care, the following remedies will be employed: PBGV Lifeline will be legally authorized to remove the Dog from you upon demand. To this end you will allow followup visits to your home (possibly unannounced) to assess the status of the Dog and the conditions under which it is being kept. After the demand for return of the Dog, you will immediately surrender the Dog to us. In addition, without waiving any of our rights under this Contract, you will owe us a payment in the amount of $250, agreed between us to be just and reasonable liquidated damages to compensate us for our costs and expenses in connection with your breach of this contract. 10. No Liability. PBGV Lifeline is not responsible for any costs, claims, legal actions, losses, injuries, damages or liabilities whatsoever in connection with your adoption or ownership of the Dog. 11. Entire Agreement/Modification/Binding Effect. This Contract (including all terms and conditions of the Spay/Neuter Agreement, if applicable) constitutes the entire agreement between you and PBGV Lifeline and supersedes any prior understandings between you and us with respect to the subject matter of this Contract. No modification of this Contract will be valid unless detailed in writing and duly signed by both you and us. This Contract is binding you and your heirs, assigns, successors, personal representatives and executors. This agreement between the parties is contained herein. Dated: ___________________________ ADOPTER: PBGV LIFELINE _____________________________________ By ____________________________________ (Signature) (Signature) ______________________________________ _______________________________________ (Print Name) (Print Name) ______________________________________ (Street Address) : ______________________________________ Followup Contacts: (City, State, Zip) ______________________________________ First: __________________________________ (Telephone) ______________________________________ Second: ________________________________ (Email) Amount Paid: ___________________________ Third: _________________________________ ( Cash / Check / Money Order ) Additional Donation: ______________________ |
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