Concerned Citizens Animal Rescue, Inc.

A 501(3)(c) Nonprofit

www.concernedcitizensanimalrescue.org

[email protected]

(213) 797-0364


Dog Adoption Agreement

Regarding "The Adopter":
Regarding "The Dog":
Regarding “The Rescue” (Concerned Citizens Animal Rescue):
The Adopter agrees to the following (please be sure to initial #10):
1. The Adopter is taking possession of The Dog to treat and to be responsible for it as their own dog.

2. The Dog will be treated as a family member with loving care and affection. The Adopter will do his/her best to ensure The Dog’s safety and well-being.

3. The Adopter will provide The Dog with proper humane care, food, water, shelter, exercise, and all other necessities.

4. The Dog will live inside The Adopter’s home and will not be isolated from the family. The Adopter will walk The Dog on a leash or exercise. The Adopter will never let The Dog run loose or roam, keep The Dog chained or tied up, keep it continuously in a yard, garage, patio, balcony, or pen, or leave The Dog outdoors, even in a fenced yard when no one is at home.

5. The Adopter will not have The Dog attack-trained nor use The Dog for any purpose other than companionship.

6. The Adopter will not have The Dog’s ears cropped nor will have its tail docked. The Adopter will never allow any physical, mental, or emotional abuse of The Dog.

7. The Adopter will take The Dog to a licensed veterinarian when shots are due but in no event later than one year from the last vet visit. The Adopter will provide all required and/or needed veterinary care, including: rabies shots as required every one or three years; yearly booster shots for DHLPPC; yearly fecal checks for internal parasites (worms); and prompt treatment by a licensed veterinarian for any illness or injury.

8. The Dog will be given (if needed) heartworm preventative tablets every month, all year long. I will have a heartworm test given every year. If there is any break in dispensing heartworm tablets, I must retest for heartworm and restart tablets immediately.

9. STERILIZATION OF ANY ADOPTED ANIMAL IS REQUIRED. A PERSON WHO VIOLATES THIS ARTICLE IS SUBJECT TO CIVIL PENALTY. THE NEW OWNER MAY BE COMPELLED TO COMPLY WITH THE PROVISIONS OF THIS ARTICLE.
10. If not already done, The Adopter will have The Dog spayed/neutered by the age of 6 (six) months if the dog is a puppy. and will immediately forward proof. If the animal is an adult dog and intact, adopter has 30 days to remit sterilization certification. Failure to comply with this requirement will result in the immediate return of The Dog to Concerned Citizens Animal Rescue.
11. The Adopter affirms that no member of The Adopter’s household has been convicted of an animal welfare law violation such as neglect, cruelty, abandonment etc.

12. The Adopter will ensure proper licensing of The Dog and will attach the appropriate license tags, rabies tag, name tag, and personal identification tag to a non-choke collar to be worn at all times. The Adopter will ensure compliance with all applicable local and state statutes.

13. The Adopter will not use a choke-type collar at any time, except for training under the guidance of a qualified dog trainer.

14. The Adopter is adopting The Dog for him/herself and he/she agrees to not give away, sell, or trade The Dog, even as a gift to a friend or family member. The Adopter will neither breed nor take The Dog to a shelter or another rescue, nor abandon The Dog. The Adopter understands that The Adopter must notify Concerned Citizens Animal Rescue, without delay, if The Adopter can no longer care for or keep The Dog and agrees to give reasonable time to rehome The Dog or place The Dog in an approved foster home, if available. The Adopter must notify Concerned Citizens Animal Rescue of any behavioral problems that have occurred at any time before returning The Dog. The Adopter agrees to pay for a professional trainer’s evaluation in the case of biting or aggression.

15. The Adopter agrees to accept responsibility and ownership of The Dog at his/her own risk and releases Concerned Citizens Animal Rescue and its agents from any and all liability arising out of possession and ownership of The Dog. The Adopter agrees to assume financial responsibility for The Dog as of the date of this Adoption Agreement. Concerned Citizens Animal Rescue and its agents will not be held responsible for any damages or expenses (veterinary or other) incurred during ownership of The Dog.

16. The Adopter agrees to take The Dog to obedience training classes as a puppy, and/or as an adult.

17. The Dog’s known background and medical history have been discussed with The Adopter. The Adopter understands that Concerned Citizens Animal Rescue has made no representation concerning the breed, health, condition, training, behavior, or temperament of The Dog (including, but not limited to, giardia, coccidia, common parasites, Parvo, distemper, influenza etc.).

18. If The Dog is microchipped, The Adopter agrees to register The Dog under his/her own name.

19. The Adopter agrees to permit Concerned Citizens Animal Rescue to make inquiry about and enforce any of the above conditions and requirements at any time after adoption. This can include visits to The Adopter’s home and contact with The Adopter’s veterinarian.

20. To comply with all state and local ordinances in the confinement, care, and licensing of this pet, The Adopter will reclaim The Dog promptly, and pay any required fees if it is picked up by an animal control agency. If The Dog is ever stolen or lost, The Adopter agrees to take all reasonable steps to find The Dog and will immediately notify Concerned Citizens Animal Rescue. Such reasonable steps include, but are not limited to, posting signs in the vicinity of where the dog went missing and checking area pounds and shelters. In the event that Concerned Citizens Animal Rescue or any of its agents have to retrieve The Dog from any pound, shelter or person that is in possession of The Dog after The Adopter has been notified, The Adopter agrees to immediately reimburse Concerned Citizens Animal Rescue or its agent for any amounts expended in procuring The Dog’s safe return and Concerned Citizens Animal Rescue reserves the right in its sole and absolute discretion to determine whether The Dog shall be returned to The Adopter or retained by Concerned Citizens Animal Rescue. If adopter dumps the dog at a shelter, in the street, gives the animal away to a friend without notify Concerned Citizens Animal Rescue it will be considered abandonment. And charges for animal abuse are felonious.

21. Adopter may never, under any circumstance, euthanize the animal. Adopter must make Concerned Citizens Animal Rescue Inc. aware immediately of any illness or aggression. Vet records must be provided to Concerned Citizens Animal Rescue Inc. immediately. Violation of this term will result in legal action.
I HAVE READ THIS AGREEMENT CAREFULLY AND FULLY. I UNDERSTAND THAT FAILURE TO COMPLY WITH ANY OF THE ABOVE PROVISIONS WILL RESULT IN FORFEITURE OF THE DOG TO CONCERNED CITIZENS ANIMAL RESCUE.

I ACKNOWLEDGE THAT ADOPTING A DOG IS A 15 YEAR COMMITMENT. I UNDERSTAND THERE WILL BE A NON-REFUNDABLE ADOPTION DONATION. ALL MONIES GO TOWARDS SAVING ANIMALS ON DEATH ROW.

Indemnity Waiver, Release of Liability, and Assumption of Risk

I hereby agree that I will assume full responsibility for personal injury, property damage suffered and/or death sustained in connection with this animal.

I agree, for purposes of this agreement, to release all employees, agents and/or volunteers collectively from and against all liability, claims, demands, damages to my person or property suffered and/or sustained as a direct and/or indirect result of my participation as a volunteer.

In connection with my participation as a volunteer, I further agree that I will not make any claim against, sue, attach the property of, and/or prosecute Concerned Citizens Animal Rescue for any personal injury, property damage, death, and/or whatever the cause of the event that gave rise to a claim.

I further understand that the behavior of domestic animals is unpredictable and that domestic animals are capable of spreading disease, inflicting serious personal injury, causing extensive property damage, and/or causing death. Knowing the risk of handling domestic animals, nevertheless, I hereby agree to ASSUME THOSE RISKS and to release indemnity and hold harmless Concerned Citizens Animal Rescue, who might otherwise be liable to me (or my heirs or assigns), for damages.

It is understood and agreed that this Indemnity Waiver/Release of Liability and Assumption of Risk form is intended to be binding on my heirs, distributes, guardians, legal representatives, and/ or assigns.

I HAVE READ THIS AGREEMENT CAREFULLY AND FULLY. I AM AWARE THAT THIS IS AN INDEMNITY WAIVER/RELEASE OF LIABILITY AND ASSUMPTION OF RISK FORM AND IS A BINDING CONTRACT BETWEEN CONCERNED CITIZENS ANIMAL RESCUE AND MYSELF. I SIGN IT OF MY OWN FREE WILL.