Adoption Agreement

Border Collie Rescue
Adoption Agreement

IN CONSIDERATION of payment of _________________________ ($_______ ) dollars, the receipt of which is acknowledged, ownership is transferred to the undersigned adopter(s) who releases, discharges and holds harmless Border Collie Rescue and anyone else associated with Border Collie Rescue from any charges or claims arising from the adoption of:

(Name of Dog) __________________________________

(Description) ___________________________________

on (Date) ______________________________________

THE UNDERSIGNED agrees to abide by the "Terms of Adoption" listed below:

1. Return: The above-designated dog may be returned to Border Collie Rescue within two weeks of the above date for a full refund of above-specified payment if the adopter is not satisfied with any aspect of the adoption. After two weeks from the above date, no refund will be given even if the dog is returned to Border Collie Rescue.

2. Transfer of Ownership: The above-designated dog may not be transferred to any other person for any reason. If the undersigned adopter is forced to relinquish custody of the dog at any time, said dog will be relinquished only to Border Collie Rescue.

3. Refund: There will be no refund or reimbursement for any expenses incurred by the adopter for the above-designated dog, even if it is returned to Border Collie Rescue.

4. Health Program: The above-designated dog will be cared for humanely, including adequate food, shelter, water and veterinary care and will be licensed in accordance with the laws of the jurisdiction in which he resides. The dog is to be exercised in a fenced yard or on a leash and NOT TO BE FREE TO ROAM THE STREETS.

5. Reason for Adoption: The above-designated dog is to be kept as a house pet; it shall not be used for medical or any other experimental purpose; it shall not be chained or tied, and it shall not be used for breeding.

6. Loss: If the above-designated dog is lost or stolen, the adopter will notify Border Collie Rescue within three (3) days.

7. Reservation of Rights: Border Collie Rescue reserves the right to enforce this contract in order to protect the welfare of the above-designated dog. It is understood that Border Collie Rescue may examine and may make inquiry about said dog at any time. If the terms and conditions of the Agreement are not upheld, Border Collie Rescue reserves the right to terminate this Agreement and to reclaim the dog.

8. Return check charge: There will be a $15.00 charge on all returned checks submitted by the adopter.

Adoption Release

NEW OWNER(S) NAME:_______________________________________________
ADDRESS:______________________________________
______________________________________________
PHONE:_______________________ WORK:________________________
ADDITIONAL INFORMATION:___________________________________________
__________________________________________________________________
__________________________________________________________________
IDENTIFICATION (Driver's License or I.D. Card)_____________________________

INFORMATION ABOUT DOG

CURRENT NAME:____________________________________________________
AGE:__________ COLOR:__________________________ SEX:________
RESCUE NUMBER____________________

MEDICAL

SPAYED OR NEUTERED:________________ DATE:______________________
RABIES VACCINATION:________DATE:__________________EXPIRES:_______________
OTHER SHOTS AND DATES:_________________________________________
__________________________________________________________________
__________________________________________________________________
__________________________________________________________________
ALLERGIES:______________________________________
MEDICINE______________________________
DEWORMING:_________________________________DATE_________________

DOG LIKES

WATER:____ CHILDREN:______ CATS:______ OTHER DOGS:______
STRANGERS:______ PLAY:____ RIDES IN A CAR:______
SPECIAL TOYS:________________________BLANKET:______
OTHER:____________________________________________________________
__________________________________________________________________
__________________________________________________________________
HABITS: HOUSEBROKEN:____
SIGNAL TO GO OUT:______________________________
JUMPS FENCES:____ DIGGING:______
CHEWS FURNITURE OR OTHER ITEMS:__________
TRICKS:___________________________________________________________
__________________________________________________________________
__________________________________________________________________
LEASH TRAINED:______COLLAR:____HALTER:______
TRAINING RECEIVED_______________________________________________________
___________________________________________________________________________
DEGREES:__________________________________________________________________
____________________________ OTHER:________________________________________
___________________________________________________________________________
FEEDING INSTRUCTIONS:___________________________________________________
___________________________________________________________________________
___________________________________________________________________________
SUPPLEMENTS:_____________________________________________________________

ADDITIONAL INFORMATION

I hereby acknowledge receipt from Border Collie Rescue of the dog described above. I accept the dog as is and assume all risk and financial responsibilities of ownership. I hereby release Border Collie Rescue from any liability associated with any illness of the dog or damage, accident or injury hereafter caused by said dog. I agree that Border Collie Rescue will not in any way be held responsible for the conduct of this dog after its adoption. I understand that some or all of the information provide on the Adoption Agreement regarding said dog may have been received by Border Collie Rescue from a third party; I understand that Border Collie Rescue does not warrant the accuracy of such information. In addition if the dog was found wandering or lost, I acknowledge that Border Collie Rescue has no knowledge of the prior owner(s) of the dog, and that the prior owner(s) may contact me at any time with regard to retaking the dog. If this occurs, the only remedy I will have is that Border Collie Rescue will provide me with another dog, if and when one is available and I so desire, at no additional cost to me. If at any time I desire to relinquish custody, or Border Collie Rescue demands its release for failure to comply with agreement, I agree to return said dog to Border Collie Rescue making no charges of any nature for licensing, care, food or other services or items. I agree to pay any reasonable attorney fees and court expenses if Border Collie Rescue must bring legal action against me to enforce this Adoption Agreement. I understand that any sum of money I have given to Border Collie Rescue is to be used for its work in caring for this and other Border Collies and is not refundable except as provided in "Terms of Adoption" number 1.

I hereby acknowledge that I have read and understand this Adoption Agreement and agree to abide by all of its rules and regulations set forth herein. I pledge that I will keep the dog described herein as a part of my family.

Signed this ______________________ day of _______________________, 19____ .

Agent for Border Collie Rescue ___________________________________

Signature of Adopter ___________________________________

Signature of Co-Adopter (if any) ___________________________________