This is the form you will be required to fill out when you come into the shelter!!! Please DO NOT print this form out and bring it. Otherwise you will have to do another one at the shelter. This is for reference ONLY!
It is important to ask a staff member questions to help you better understand the lifetime commitment you are about to make.
INITIALS NEXT TO EACH REQUIREMENT BELOW WILL SERVE TO SHOW THAT I ACKNOWLEDGE
EACH STATEMENT AND AGREE TO THE TERMS OF THIS ADOPTION.
_____ I understand that I am not PURCHASING a pet but ADOPTING and SAVING THE
LIFE of an orphaned pet and therefore there is NO TRIAL PERIOD
and will be NO refund for ANY reason other than the pet being terminally ill
(and this is confirmed by one of our vets)..
The dog/puppy I am adopting will be left alone daily for _____ hours.
I do hereby adopt this animal for MYSELF and MY FAMILY (not as a gift or
companion for anyone OUTSIDE the home at the address below) and agree to take
good care of it and protect it from abuse, neglect or abandonment and to keep
the animal as a house pet and not allowed to run free, to provide proper medical
care and to provide proper mental stimulation and love. I understand that my
adoption is a LIFETIME commitment and I will NOT give up on my newly adopted pet
for any reason - other than TERMINAL illnesses or SEVERE aggression, which has
been confirmed by a Licensed Vet and/or PROFESSIONAL TRAINER OR
I am prepared to keep this pet for its entire life and I am prepared for
all aspects of pet ownership both emotionally and financially($400-$1,000 yearly
not including emergencies). HOWEVER, If I do choose to give up my pet, I MUST
return it to the shelter and not give it to anyone else, and I may be charged a
surrender fee dependant on my reason for surrender, medical and vaccination
history, length of time I have owned the pet, and the condition of the pet when
I surrender him/her. I must also
call the shelter before returning the pet due to space and availability
By signing this contract I acknowledge that the entire family is in
agreement of this adoption, that I am 21 years of age or older, that I own my
own home or have written landlord’s permission and that there are NO PET
ALLERGIES (that cannot be controlled with medication) in the home where the pet
I also understand that I will not receive a refund IF I AM or MY family
develops or has existing allergies to the pet.
I also understand that I will not receive a refund IF I AM or MY family develops or has existing allergies to the pet.
I understand that the shelter CAN NOT & WILL NOT guarantee the
health, breed, temperament or age of this pet and agree that I should never
leave my pet unattended with children. Because I understand that my pet may need
help in the transitional period and possibly even YEARS from my adoption date,
I agree to work with a PROFESSIONAL& ACCREDITED trainer or behaviorist if
the pet has or develops behavioral problems at the time of my adoption and/or
the years coming.
I am willing to give my pet an unlimited time to adjust to his/her new
home and I understand that there may be behavioral issues with my new pet, such
as hiding, shyness, not eating, growling, diarrhea, accidents, destructiveness
and a variety of other issues. I was advised and will be provided documentation
about crate training or litterbox training and tips and tricks to help a new pet
adjust to his home. It is my responsibility to follow the shelter’s
suggestions and do research on making my pet a better member of my family. Many
of these important tips can be found in my adoption literature pack and on their
I understand that though this pet may appear healthy at this time, it may
in fact be in the 1st stages of an Upper Respiratory Infection/Kennel
Cough, Skin problems, ear/eye Infection or Parasitic infection or have a variety
of other medical problems - some of which may be contagious to other pets. It is
recommended that I keep other pets away from the newly adopted pet until a
complete check-up AND FECAL sample has been done for him/her and this is why the
shelter has advised me to obtain a physical for my newly adopted pet within 14
days of my adoption or 10 days post-op if surgery was performed. If the vet specified
by the shelter does this physical, it is at no cost to me.(All
shots, test, and vaccines will still be at my own cost.) If I choose to take the
animal to any other vet FOR ANY REASON it will be at MY OWN COST.
This mandatory fee of $_______ will be applied towards general upkeep of
the shelter, vet care, other pets in the shelter, food, heat, electric, phone,
staff, and general expenses. (The shelter runs strictly on adoption / surrender
fees and these fees are what pay any and all bills incurred by the shelter. The
shelter is NOT funded by state, town, city or government funds.) I understand
the shelter has done all that they can for my pet medically prior to him/her
leaving. I am FULLY responsible for any and all medical bills incurred by my pet
and I will NOT be refunded any money for any reason. It has also been
recommended to me that I seek any medical care for my pet through participating
shelter vets who work with the shelter animals at a lower cost. I also agree to
have A FECAL SAMPLE run at the 1st health check as this is crucial to
uncovering any possible parasites that may harm my pet.
I hereby agree that any default of these conditions by myself will
immediately void all rights and interests I have gained in the animals and that
I will turn it back over to the shelter and should the shelter have to initiate
any action, legal or otherwise, to regain such animal, I agree to indemnify and
reimburse said shelter for all attorney’s fees and witness expenses including
travel and loss of pay involved therein.
If my new pet bites, I WILL BE RESPONSIBLE for the quarantine time OF 10
DAYS. I must also notify the shelter, dog officer and/or my town’s Board of
Health. If the pet bites or does any destructive damage to me or anyone else,
from this date and time, I understand that is my responsibility and agree not to
hold any person, employee, director, officer or volunteer of the shelter,
NOTE: The Animal Shelter Inc. has limited information on these animals and CAN NOT and WILL NOT guarantee the health or temperament on these animals. Turnover rate at the shelter is incredibly high; some animals are here for virtually minutes. The shelter trusts the surrendering family to provide accurate and truthful statements regarding their animals. However some animals are stray and we often find that people do not tell the truth about why they are surrendering their animal. Please understand the Animal Shelter Inc. is dedicated to placing happy and healthy animals. As an adopter, you may know just as much or as little as the shelter staff does. Please make sure your decision is not taken lightly and understand this is A LIFETIME COMMITMENT. We work hard to place these unwanted animals into a home for life.
Animal Shelter Inc.
17 Laurelwood Road
Sterling, MA 01564
Copyright © 1998-2013 Animal Shelter, Inc.