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Cherryland Humane Society - Home
Adopt a Dog

MURPHY
Male 4 mo.

Adopt a Cat

MAYA
Female 1 yr.

 

Adoption
Adoption Contract

PET INFORMATION

Adoption Date
Name
Breed
Color
Age Approximate Weight
Markings
ID#
Species Dog    Cat
Sex Male   Female
Spayed/Neutered Yes   No
Housebroken Yes   No

This animal received a Canine DA2LP-P or Feline FVRCP Vaccination on . A booster vaccination is due one month from the above date.

This animal was wormed with Pyrantel Pamoate on . A stool sample should be taken to your veterinarian and examined for worms.

ADOPTION CONTRACT - NOTICE - READ BEFORE SIGNING.

1. I accept responsibility for this animal and agree to provide adequate shelter, food, water, veterinary care, and will not allow the animal to run loose.
2. I AGREE TO HAVE THIS ANIMAL NEUTERED/SPAYED BY THE MONTH OF , 20 . In accordance with the state law the sterilization deposit is forfeited if the due date is not met.
3. I agree to have the animal licensed and rabies vaccinated in accordance with state and county ordinances.
4. I agree that the animal is to be kept and used solely as a pet and I agree to return the animal to the Cherryland Humane Society if I desire to relinquish custody at any time.
5. I understand the adoption fee is NON REFUNDABLE, but that I may return the pet within thirty days, if it fails to adjust to our household, or within two weeks of the adoption date if diagnosed as unhealthy.
6. I understand that the expenses incurred, including veterinary care, are my own responsibility since I have the option of returning the animal to the shelter within two weeks.
7. I fully understand that after adoption, the Cherryland Humane Society may examine and inquire about the animal.
8. LIQUIDATED DAMAGES: Adopter agrees to pay Cherryland Humane Society the sum of $150.00 as liquidated damages in the event the terms of this contract are breached. This liquidated damage value is agreed to for the purpose of establishing value of the animal, and does not bar the Cherryland Humane Society from seeking return of the animal by a judicial process or other legal means. Adopter agrees to pay reasonable attorney fees and court costs in the event this matter is forwarded to an attorney for enforcement.
9. I do hereby, and by these presents, forever expressly release the Cherryland Humane Society and its agents from all liability which may occur as a result of the adoption of this animal.

I have read this section; I have had it explained to me and I completely understand and accept the rights and obligations involved.

Name
Home Phone
Work Phone
Email
Address
City
State Zip Code
Social Security or Drivers License No.
 
Date  
Signature