| PBGV Lifeline Sterilization Agreement |
| This sterilization agreement is entered into by PBGV Lifeline, Rescue, and the undersigned person ("Adopter/you") adopting a dog from us. PBGV Lifeline and the adopter are entering into this Sterilization Agreement, intending to be legally bound by it. In consideration of the mutual promises in this Sterilization Agreement, and other good and valuable consideration, PBGV Lifeline and the Adopter agree to the following terms and conditions: 1. The Dog. We have agreed to your adoption of the following described dog/puppy (the "Dog") as in the Adoption Contract signed by us and you; provided that, among other things, you will also sign this Sterilization Agreement. To the best of our knowledge, the Dog is not yet sterilized. Name:____________________________________________ Male _____ Female _____ Date of Birth: ______________________ AKC reg # (if known) _____________________________ Color/Markings: ____________________________________ Weight: _______________________ ID Type: Microchip __________________________ Tattoo ________________________________ 2. Sterilization Deposit.. You accept the Dog described above and agree: (a) To pay us $60 as a sterilization deposit, which is part of the adoption donation, on the date that the Adoption Contract and Sterilization Agreement are signed. (b) If you fail to comply with the terms of this Sterilization Agreement, you agree to forfeit the deposit and return the Dog to us, if we notify you that we want to reclaim it. 3. Requirements to Satisfy This Agreement. We agree to release the above-described Dog into your care and refund your sterilization deposit after the adoption, provided that: (a) The Dog is sterilized by a licensed veterinarian no later than _____________________(date), and (b) We receive from you a copy of the statement from the veterinarian showing that the Dog has been sterilized, or (c) We receive from you a letter from a licensed veterinarian stating that the Dog was already sterilized, or can never be sterilized due to old age or a health condition that would likely result in the death of the Dog, or (d) We receive reasonable proof from you that the Dog died before the specified date, or (e) If you do not want a refund of your sterilization deposit, you must still submit proof that the Dog has been sterilized, with a written statement that your sterilization deposit is a donation to PBGV Lifeline. 4. Entire Agreement/Modification/Binding Effect. This Sterilization Agreement and the Adoption Contract constitute the entire agreement between us and you with respect to the subject matter of this Agreement. Any modification to this Sterilization Agreement must be detailed in writing, duly signed by both you and us. This Sterilization Agreement is binding upon our and your heirs, assigns, successors, personal representatives and executors. Dated ________________________ ADOPTER PBGV LIFEINE _____________________________________ By _____________________________________ (Signature) (Signature) ______________________________________ _______________________________________ (Print Name) (Print Name and Title) |
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