www.dgr.petfinder.org Do you agree that the animal is being adopted for yourself and will not be sold, adopted or given to another party? __Yes __No Do you agree that the animal will not be allowed outdoors without proper supervision? When taking the animal outdoors, do you agree that he or she will be on secure harness and wear proper ID? __Yes __No If adopting a cat, do you agree that you will NOT declaw the cat or allow the cat outdoors? __Yes __No If adopting a dog, do you agree that this dog is to be a companion animal and not a guard dog? Do you agree that the animal will live inside your home, and not outdoors or in a business location? __Yes __No Do you agree to care for the animal in a humane manner and to be a responsible animal guardian? This includes supplying adequate food, water, shelter, attention, excercise, medical care and affection. __Yes __No I agree that if at any point I cannot keep the animal, I will return him/her to Derreks Gleeful Rescue without requesting a fee. __Yes __No I understand and agree that Derreks Gleeful Rescue makes no guarantees about the animal's temperament, age or health and is not responsible for future damages or injuries caused by the animal. __I Agree __I Disagree I give Derreks Gleeful Rescue permission to call my home at any reasonable hour to assure that the animal is being properly treated and cared for. __I Agree __I Disagree I agree to keep Derreks Gleeful Rescue informed of my current address and phone number. __I Agree __I Disagree I, (name/s) am applying to adopt the following animal: (Name of pet) (Species) All animal adoption contracts approved by Derreks Gleeful Rescue are subject to the following terms and conditions: The adopter agrees that the animal will be kept as a domesticated house pet. This means that dogs are kept indoors except for periods of exercise in a fenced-in area or on a leash. Cats will be kept indoors at all times unless a screened-in porch or similar-type enclosure is available. The adopter agrees that if the animal is not already spayed or neutered, the animal will be spayed or neutered within 14 days of the date on this contract and proof will be provided to Derreks Gleeful Rescue within 21 days of the date on this contract. The adopter further agrees to provide proper veterinary care for the animal. The adopter grants Derreks Gleeful Rescue the right to make periodic visits to the adopter's premises for the purpose of checking on the health and general welfare of the animal and to verify that the animal has been spayed or neutered in accordance with the terms of this agreement. The adopter represents that all household members have agreed to the adoption of the animal and that all household members will abide by the terms of this agreement. The adopter further represents that he/she is eighteen years of age or older. The adopter represents that he/she has never been subject to legal action for cruelty to or neglect of animals. The adopter further represents that he/she has never owned an animal which has been confiscated by an animal control officer or humane organization for violations of state or local animal control regulations or animal adoption agreements. If the adopter is a tenant, the adopter agrees to provide written permission from the landlord consenting to the animal adoption. If for any reason the adopter is unable to provide care to the animal, the adopter agrees to return the animal to Derreks Gleeful Rescue The adopter shall not offer the animal for sale or give the animal to any third party without the prior written consent of Derreks Gleeful Rescue The adopter agrees that Derreks Gleeful Rescue shall have the right of immediate possession of the animal if, in the judgment of Derrek's Gleeful Rescue, the animal is receiving inadequate care, is being improperly housed or handled or has not been spayed or neutered by the specified date. The adopter hereby declares that he/she is aware: (a.) That animals are different from human beings in their responses to human actions; (b.) That the actions of animals are often unpredictable. (c.) That the animal's behavior may change after it leaves the shelter or other environment and accustoms itself to its new environment; (d.) That Derreks Gleeful Rescue makes no claims as to the temperament, health or mental disposition of any animal put up for adoption; (e.) That the adopter herby accepts possession, legal guardianship and responsibility for the animal referenced in this contract and discharges DGR forever from liability for any injury or damage to any person or property caused in the future by said animal, and from any causes of action, claims, suits, or demands whatsoever that may arise as a result of such injury or damages. (f.) That the adopter has received a copy of Derreks Gleeful Rescue Animal Adoption Contract Terms (Please print for your records). I hereby declare that I am the adopter whose name is affixed below, and all of the information I have provided is true and complete to the best of my knowledge. __I Agree __I Disagree Signature (Typing in this box acts as your signature) Thank you for caring about a homeless animal. Your pet will never forget that you saved its life!