American Charitable Trust for Dandies

(Hereinafter referred to as ACT for Dandies)

Adoption Agreement

I, the undersigned, agree to adopt the Dandie Dinmont Terrier named______,

age______, sex______. The following terms and conditions are set forth by ACT for Dandies

and this agreement of adoption shall constitute a legal and binding document.

1. Pre-adoption Visit. Persons wishing to adopt a dog from ACT for Dandies must permit a

pre-adoption visit to the home in which the dog will reside, as well as a post-adoption visit, at

a mutually convenient time.

2. Return. If it becomes necessary to relinquish custody of the dog, the adopters agree to return

said dog to ACT for Dandies and shall not sell or transfer ownership to any other person or

business. Adopter agrees to give ACT for Dandies 14 days to arrange for a suitable foster home.

3. Transfer of Ownership. The said dog may NOT be transferred to any other person, firm,

corporation, or organization for any reason without the express written consent of ACT for

Dandies.

4. Microchip and Identification. ACT for Dandies will microchip said dog prior to adoption, if

not previously done. Adopter will transfer or complete microchip registration within 30 days of

adoption, listing ACT for Dandies permanently as an Alternate Contact. Adopter will apply

for a dog license immediately and keep said license current.

5. Health Program. Adopter will have the said dog tested for heartworm and begin an appropriate

preventative program. An appropriate inoculation program, fecal check, and general exam

by a licensed veterinarian will be done annually by adopter to assure and maintain the health

of the dog.

6. Housing. Adopter agrees to provide comfortable areas within their residence for the rescue dog.

SAID DOG MUST NOT BE MAINTAINED OUTSIDE AS A YARD DOG. The only function

of a rescue dog is that of a house pet.

7. Exercise. Adopter will provide fenced yard and/or will leash walk the dog 2 times per day.

Any choke collar is to be removed when dog is unattended.

8. Daily Care. Adopter accepts full responsibility for maintaining a high level of care for the dog,

including proper food, water, grooming, sanitation, exercise, attention, safety, shelter, veterinary

care, training, and any other provisions necessary for the physical and emotional well-being

of the dog.

9. Abuse. Adopter avows that no family members have ever been charged with cruelty to animals.

It is also acknowledged that the signer of this agreement has never been cruel to animals.

10. Cruelty. Said dog will not be abused or treated cruelly and will not be subject to any type of

experimentation or laboratory testing.

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ACT for Dandies ADOPTION AGREEMENT Page 2 of 3

11. Training. Under no circumstances will rescue dog be trained for or used for protection, fighting,

attack or guard use. SAID DOG MUST NOT BE MAINTAINED OUTSIDE AS A

WATCHDOG. The ONLY function of a rescue dog is as a house pet.

12. Spaying/Neutering. Dogs will normally be spayed/neutered before going to any new home.

If this is not done, adopter agrees to have dog spayed/neutered within 30 days. THE DOG

MAY NOT BE USED FOR BREEDING PURPOSES UNDER ANY CIRCUMSTANCES.

Adopter must send ACT for Dandies a copy of the spay/neuter certificate signed by the this

Veterinarian who performed the surgery. ACT for Dandies reserves the right to terminate

agreement and the adopter agrees to relinquish custody of said dog upon demand, if this

stipulation is not upheld.

13. Loss. Adopter agrees, if dog is lost or stolen, to notify ACT for Dandies immediately by

e-mail or telephone and to make extensive efforts to locate the dog by making reports to law

enforcement agencies and shelters, notifying area veterinarians, placing ads in local

newspapers, and checking online adoption sites (e.g. Petfinder).

14. Address Change. Adopter will notify Act for Dandies within 30 days of any change in address,

phone number or e-mail address.

15. Euthanasia. If said dog becomes terminally ill with deteriorating disease or is in

untreatable pain, adopter has the authority to humanely euthanize the dog. NO OTHER

PROCEDURES WILL BE USED TO END THE DOG’S LIFE.

16. Attorney Fees and Costs. If ACT for Dandies, or representative thereof, determines that terms and

conditions of this agreement have not been met, or that said dog is not receiving proper humane

care, adopter agrees to immediately surrender custody of the dog upon demand. Should it become

necessary to litigate any dispute, adopter agrees to pay all court costs, attorney fees and other

costs of litigation.

17. Disclosure. ACT for Dandies makes no promises or guarantees concerning said rescue dog,

including temperament, behavior or genetic defects.

18. Disclaimer. In consideration of payment of $______, the undersigned adopter releases and

holds harmless ACT for Dandies rescue efforts, persons designated to have authority for operation

of rescue efforts, their designated agents, and any other person, their heirs and executors from any

and all claims, damages, costs, or expenses arising out of any act or occurrence from present time

forward and on account of said rescue dog named______.

19. Release. Should any illness and/or actions of said rescue dog be subject to litigation, the

undersigned agrees to release and hold harmless the ACT for Dandies rescue effort, or any

persons or representatives acting on behalf of ACT for Dandies.

20. ACT for Dandies reserves the right to visit the home in the future to check on the condition of the

dog and its adjustment.

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ACT for Dandies ADOPTION AGREEMENT Page 3 of 3

20. ACT for Dandies reserves the right to visit the home in the future to check on the condition of the

dog and its adjustment.

21. Cruelty Fines. At no time will said dog be ever harmed, treated with cruelty, or abandoned by

adopters or by anyone responsible for temporary care. Should any of the aforementioned acts

occur, adopter will be liable in the amount of one thousand five hundred dollars ($1,500.00),

payable to the American Kennel Club Humane Fund, 260 Madison Ave., New York, NY 10016.

22. Adopter also agrees to pay ACT for Dandies an adoption fee of $ 350.00.

Adopter Signature______Date______

Printed name of Adopter______

Address______

City______State______Zip Code______

Home phone______Cell phone______

Fax______e-mail______

ACT for Dandies Representative Signature______Date______

Printed Name of Representative______

May2012