Veterinarian *
Driver's License Number *
Dog or Cat: Select. *
Choose one:
Cat
Dog
Please indicate which animal you are interested in adopting? *
Female or Male: Select. *
Choose one:
Female
Male
Age of Animal *
Breed/Description *
I agree that the animal adopted on this date is for myself and will not be
sold, adopted, or given to another party in any event and that the animal will be returned
to Friends of Bedford County Animal Shelter in the event, it cannot be cared for without
requesting a fee.
Initial *
I agree the animal will be spayed/neutered within 60 days of this contract being
executed.
Initial *
I agree the animal is to live in a private residence as a companion animal and will not be
allowed outdoors without proper supervision.
Initial *
I agree the animal will never be given to any medical facilities whose purpose is to
experiment or cosmetically alter the animal.
Initial *
I agree that under no circumstances will the animal be declawed or otherwise altered in
any way unnecessary to their health or quality of life.
Initial *
agree to care for the animal in a humane manner and be a responsible guardian. This includes providing adequate food, water, shelter, attention, and medical care.
Initial *
I agree that I have never been convicted of cruelty to animals at any time, and have no court orders stating that I may not adopt or care for any animal.
Initial *
I agree there are no guarantees about the temperament or physical condition of the animal being adopted and the original caregiver is not responsible for any damages or injuries cased by the animal in the future or any medical conditions the animal may have.
Initial *
I agree that this contract never expires for the lifetime of the animal.
Initial *
I agree that if this contract is broken or the animal is in an unsafe environment under the opinion of the original caregiver that the animal will be confiscated from me by the original caregiver.
Initial *
I agree to all of the above obligations of this contract and that I have signed truthfully and lack of truth will result in a breach of contract and that in the event of any such breach of contract, I authorize the original caregiver to confiscate the adopted animal from my residences.
Initial *
Please type your name and date to certify that all information provided is accurate and truthful, and that you have read and agreed to our disclaimer stating that FOBCAS reserves the right to deny any application. *
Date: *
I agree that the original caregiver may contact me at a reasonable time to check on the adopted animal.
Initial *
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