Adoption Contract

By Jean Gibson,2014-05-05 19:14
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Adoption Contract

Adoption Contract


This Sample Adoption Contract is made available by

    Pets Channel Moderator, Psychedelicstar,

    for your reference only.

It is not an endorsement of any sort and you are solely

    responsible for your usage and/or modification

    of the adoption contract.

    If you are not agreeable to the above,

    DO NOT use this adoption contract.

    Page 1 of 6

Adoption Contract

    Adoption Contract

In order to be considered to adopt a pet, you must:

    ? Be 18 years of age or older;

    ? If you are below 18 years, a parent or legal guardian should fill in the form;

    ? Have the knowledge and consent of your landlord if you currently rent;

    ? Have identification (of the same person who is filling up the form) showing your

    present address (example: NRIC) for verification purposes only;

    ? Be able and willing to provide a loving, safe and peaceful environment for the pet;

    ? Be able and willing to spend the time and money necessary to provide training,

    medical treatment and proper care for the pet.

Adopter’s Information

    Full Name (as in NRIC): ___________________________________________________ NRIC Number: ______________________ Age: ______________________________ Address: ____________________________________________________________ ________________________________________________________________________ Phone Number: _____________________ (Home) _______________________ (Mobile) Email Address: ___________________________________________________________


Describe in detail why you wish to adopt the pet:

Would this be your first pet? Yes No

    If not, give details of present or past pets:

What other animals do you currently have?

Have they been spayed or neutered? Yes No None

    If you have other pets, will they adjust to a new pet entering the household? *

    (Current Pet #1) Which of the mentioned family pets do you still have: Breed: Sex: Male Female

    Age: Spayed/Neutered: Yes No Currently on vaccinations: Yes No (If not, Why?):

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Adoption Contract

    (Current Pet #2) Which of the mentioned family pets do you still have: Breed: Sex: Male Female

    Age: Spayed/Neutered: Yes No Currently on vaccinations: Yes No (If not, Why?):

    (Current Pet #3) Which of the mentioned family pets do you still have: Breed: Sex: Male Female

    Age: Spayed/Neutered: Yes No Currently on vaccinations: Yes No (If not, Why?):

    How many adults and children are in your family and what are their ages?

    Does any member of your family have any allergies to animals?

    Do you live in a home or apartment? Home Apartment Others Others (please specify):

Is your home pet-proofed? i.e. electric cords are covered, there are no chemicals on

    the floors, plants poisonous to pets have been removed from the pet’s living and play areas, etc. Yes No

    Is someone home during the day? Yes No How many hours a day will the pet be alone? *

How much time can you spend with the pet? *

    What type of enclosure are you planning to use for the pet and where will they live? What is the size of their enclosure?

How much time will they spend in their enclosure and how much time will they be

    allowed to run around?

    Do you have a veterinarian? And if so do they have a lot of experience the type of pet that you’re adopting?

     Yes No Experienced

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Adoption Contract

    Are you willing to take responsibility if this pet acquires an illness or tests positive for medical problems/issues? Yes No

    Are you willing and able to pay the veterinary costs of caring for your new pet(s)?

     Yes No

Are you willing to take the time to work with the pet on housebreaking or chewing, if

    such problems arise? Yes No

How much time are you prepared to allow for your new pet(s) to adjust to your


    In the absence of the primary caregiver, who will care for your pet(s)?

    If you move will you take the pet with you? Yes No

    Are you willing to care for the pet and take responsibility for it for the rest of its life?

     Yes No

    Have you ever applied to adopt an animal in the past? If so, when?

     Yes No Details:

    Have you gave up your pets for adoption in the past? If so please give details: *

     Yes No Details:

A home inspection may be required. Are you willing to allow the fosterer/rescuer to

    visit your home? Yes No

     Busy (visits by friends, meetings, children, parties at


     Noisy (TV, stereo, machinery, tools, children playing,

    Describe the activity level dogs barking)

    in your home: Moderate (Normal comings and goings)

     Quiet (homebodies, few guests)

     Other (specify)

Under what circumstances would you return the pet?

     New Job Divorce New Baby Move Illness

     Other specify

    What provisions will you make for the pet should you become unable to care for it?

Please provide us with two (2) references:

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Adoption Contract

    Name: Phone: Name: Phone: Is there anything else you would like us to know?

Adopter’s Agreement

    I agree that the animal(s) is (are) being adopted for myself and will not be sold, adopted, or given to another party. _________ (initial)

    I agree that the animal(s) that is (are) adopted will not be used for commercial or breeding purposes and I agree to sterilize the animal(s) if it (they) is (are) not sterilized at point of adoption. _________ (initial)

I agree that the animal will not be allowed outdoors without proper supervision. _________


I agree to care for the animal in a humane manner and be a responsible animal guardian.

    This includes supplying adequate food, water, shelter, attention, and medical care.

    _________ (initial)

    I agree that if at any point I can not keep the animal, I will return him/her to the original rescuer/adoptor without requesting a fee. _________ (initial)

I understand and agree that the current fosterer makes no guarantees about the animal's

    temperament and is not responsible for future damages or injuries caused by the animal.

    _________ (initial)

I give the current rescuer/fosterer permission to call my home at any reasonable time to

    assure that the animal is being properly treated and cared for. _________ (initial)

I agree to keep the rescuer/fosterer informed of my current home address and phone

    number. _________ (initial)

I agree that all statements I have made on this form are true. If it is found that any

    statements I have made on this form are not true the adopted animal can be confiscated.

Adopter's Signature: ______________________________

Date: ______________________________

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Adoption Contract

Current Fosterer's Signature: ______________________________

Date: ______________________________

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