Adoption Agreement "*" indicates required fields Are you adopting a dog or cat?* Cat Dog Species*Sex*MaleFemaleAnimal’s NameBreed*Age(Months)*123456789101112131415161718192021222324252627282930313233343536373839404142434445464748Color/Markings*Spayed or Neutered (Circle One)* Yes No Adopter’s Name (Please Print) First Middle Last Date* MM slash DD slash YYYY Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country PhoneEmail* Terms and Conditions* Terms and Conditions1. ____________________________________________ the Adoptee (Adoptee) will never be given, leased, or sold to any person, laboratory, or business. If the Adopter/Foster (Adopter/Foster) wishes to relinquish custody of the Adoptee, they agree to notify Marilyn Teres; NY Pet-I-Care, Inc. Adoption Program (Pet-I-Care) and provide or agree on return transportation when a space is available. 2. The Adoptee will be kept solely as a house pet, residing in the home with the Adopter/Foster. If the Adopter/Foster moves, Pet-I-Care must be notified to update our records. 3. The Adopter/Foster will provide sufficient food, water, shelter and veterinary care. This care is to include heartworm preventative, booster shots for DHLPP as advised by the veterinarian and renewal of rabies vaccine as required by local ordinance. 4. The Adopter/Foster will provide a properly fenced-in yard and/or will leash and walk the Adoptee several times daily. Rescued dogs may chase wild animals, bark, dig, and perform other hunting actions and therefore require protection from harm. 5. The Adopter/Foster will maintain a current dog license as required by their local ordinance and will assure that the Adoptee is inoculated against disease, especially rabies. The Adopter/Foster will also see that the Adoptee always carries, at minimum, identifying tags on his/her collar. 6. No one can predict how any dog will react in a given situation, especially without complete knowledge of its background, as in the case with a rescued dog. The Adopter/Foster acknowledge this. Therefore, the Adopter/Foster are encouraged to exercise caution in introducing an adopted/foster dog to new situations, family members, other pets, and visitors. The enthusiastic reactions of some children to dogs can often frighten the dog. It is strongly recommended that a responsible adult monitor the interaction between dogs and children at all times. 7. There have not been nor can there be made explicit or implied guarantees or warranties regarding the temperament, behavior or physical condition either of the adopted dog or of its freedom from genetic defects. The dog is adopted "as is" and the Adopter/Foster assumes all responsibility for treatment of any and all existing conditions or any other conditions, physical or temperamental, that may occur. 8. The Adopter/Foster hereby acknowledges, understands, promises and agrees to hold harmless and indemnify the rescuers from any and all claims, demands, actions, causes of actions, or liability of any kind whatsoever arising out of or in connection with this Adoptee. 9. Please be advised that NY Pet-I-Care, Inc. Adoption Program and its associates will be not be held responsible or Liable for the actions of any dog when not in our immediate care and custody. All dogs adopted and or fostered are the sole responsibility of the care provider signed below. By signing this document the signer understands and agrees to Hold Harmless NY Pet-I-Care, Inc. Adoption Program and its associates from any and all Liabilities pertaining to the actions of the above mentioned dog. The below signed also acknowledges and accepts all the risks involved in the handling of this or any dog. I have read and received a copy of this NY Pet-I-Care, Inc. Adoption Program Adoption Agreement and fully understand the terms of this two page document and by signing and initialing page 1 I am bound and obligated by its terms. Date* MM slash DD slash YYYY Signature of the Adopter*Pet-I-Care Representative*What is 2 x 2= ?* this Spam Captcha is powered by Gravity Captcha. (Powered by Gravity Captcha) Δ