DOG ADOPTION AGREEMENT

The Animal Rescue of WNC

29 N. Market St. - Suite 404 Paid by Paypal on

Asheville, NC 28801 Check # Cash ____CC ____

Phone: 828-208-2411 Receipt# No Receipt

Email: Amount Paid:

Website:

Adoption DateTARWNC File# Animal Name

How did you hear about the pet? ______Driver Lic# DL State

Adopter Name

Physical Address

Mailing AddressOwn Rent

City, State, Zip Code

Phone Numbers: HomeCell:Email:

Female / Male Breed

Age/D.O.B.Color(s)

Date of Rabies Vaccination: Tag # Too young, date due:

Spayed / Neutered: Yes / No Scheduled S/N Dateat

Veterinarian

Conditions of adoption agreed to by me and The Animal Rescue of Western North Carolina (TARWNC) are as follows:

  1. Upon determination by the TARWNC, I agree for a TARWNC representative to make a visit to my home for the purpose of determining the suitability of this home for this pet or to check on the health and general welfare of the dog.
  1. I agree to NEVER chain this dog outside. The chaining of dogs can resultin serious physical, psychological and behavioral complications.

I will provide humane care, proper food, water, shelter, exercise and veterinary care.

I understand that the animal must and will be spayed or neutered.

I will not give this dog away, submit it for sale or permit it to be used for scientific/experimental uses or studies. Should it become necessary to rehome this pet, you must contactTARWNC. If your pet runs away, disappears, dies or is killed, notify the TARWNC, immediately. Failure to notify TARWNCmay affect your privilege to adopt in the future.

If the animal does not prove satisfactory, you must call the TARWNCwithin 14 days for assistance in order to receive a refund of your adoption fee. You may at anytime return this pet to TARWNC. There is no time limit. However after 14 days the adoption fee will not be refunded. Unauthorized veterinary charges will not be paid by The Animal Rescue of Western North Carolina.

I hereby accept possession of and responsibility for the animal identified above and hereby release and discharge The Animal Rescue of WNCforever from liability from injury and or damage to any person or property caused in the future and from any cause of actions, claims or suits.

I also understand the TARWNC makes no guarantee as to the house brokenness, temperament, health, or mental disposition of this animal.

I agree to pay to TARWNC the sum of $250.00 in damages in the event the terms of this contract are breached by me. This liquidated damage value is agreed to for the purpose of establishing value of the animal and does not bar TARWNC from seeking return of the animal by judicial process or other legal means.

I personally checked each box above indicating I have read, understand and agree to the terms of this contract. I am over 18 years of age or older and capable of legally contracting with The Animal Rescue of Western North Carolina.

AdopterDate

Witness Date