Humane
Society of the Palouse
Please
give careful consideration to the responsibility you assume when adopting a
companion animal. It is a commitment,
which could extend over the next 10 YEARS OR MORE. Be sure your lifestyle allows the time,
patience, and expense needed to care for the animal that, as a member of the
family, will be dependent upon you for all of their needs.
WE
RESERVE THE RIGHT TO DENY ANY ADOPTION WE FEEL UNSUITABLE.
*You must
be at least 18 years of age, with proof of age and current address
*You
understand that the adoption amount is non-refundable after the seven day
foster period
*This
agreement is legally binding
*You
understand that any false information given during the adoption process will
result in a nullification of the agreement and legal actions will be
taken.
We are placing the following described cat with you, the
Adopter, for adoption by you as an indoor
house cat unless
otherwise specified in writing:
Cats name:_____________________ sex:________
Breed:______________________
Description:______________________________________________
age:___________
Household information:
Adopter(s)_________________________________________________________________________________
Address________________________________________ City__________
State ________ Zip_____________
Mailing address__________________________________
City_________ State_________ Zip____________
Phone number:
home____________________________ Work___________________
other________________
Drivers license #__________________________ state_______
Housing (circle all that apply): own /
rent / live with parents
house / condo / apt / mobile
Landlord name:________________________________ phone #:____________________________________
Length of time at this address:________
Others living at this address (including children and their
ages):______________________________________
Where will your new cat spend its days? (Circle all that apply) Indoor
/ Outdoor / Basement / Kitchen
Garage
/ Porch / Shut in room
Where
will your new cat spend its nights? (Circle all that apply) Indoor / Outdoor / Basement / Kitchen
Garage / Porch / Shut in room
Are you familiar with trimming cats’ claws?_____ Would you
like us to help?_________
Are you willing to provide toys and scratching posts to
prevent problem scratching?____
Do you have any animals now? ___ Species:_________
Sex:_________ Fixed: ___________Age:_________
Species:_________ Sex:_________ Fixed: __________Age:__________
Species:_________ Sex:_________ Fixed: __________ Age:_________
Species:_________ Sex:_________ Fixed: __________ Age:_________
Who is your veterinarian?_______________________ phone
#:____________________
Have you gotten rid of any animals within the last
year? _______
Please describe
circumstances?_______________________________________________
IMPORTANT!!!! READ BEFORE SIGNING:
Initial each item once you’ve read and understood
it:
____ 1.
You agree to provide to the cat every day: fresh water, cat food, a clean litter box,
adequate space for play and exercise, and affection.
____ 2.
You agree not to abandon, give away, sell, or dispose of the cat in any
way, except to another person who wants to adopt the cat as a house cat, and
who will provide the same care for the cat as you are required to provide under
this agreement. If you no longer can or
want to keep the cat, and you cannot find a good, permanent home as described
above, you may make an appointment to return the cat to us. You will not ask a veterinarian to euthanize
the cat, except in the case of terminal illness or massive injury.
____ 3.
You agree to have the cat vaccinated for rabies within thirty (30) days
of adoption unless required at a later date due to age. If the cat has not finished its booster
series, it should be seen by a vet by the due date for the booster. Your cat will receive shots annually as
performed by your vet.
____ 4.
We strongly discourage you from having a declaw or tendonectomy surgery
done on the cat. HSOP and many other
animal welfare organizations are of the opinion that these practices are cruel
and inhumane.
____ 5.
You agree not to allow the animal to be used for medical or other
experimental purposes.
____ 6.
You understand that this cat was previously unwanted or lost and may
have been rescued from an unhealthy and/or cruel situation. This could result in the cats’ emotional or
physical illness. You agree that we are
making no warranties or representations about the temperament of the cat. HSOP is not liable to you or any other party
for losses, injuries, damages, or expenses whatsoever in connection with your
adoption or ownership of the cat.
____ 7.
This agreement is the entire agreement between you and us. No modification of this agreement will be
valid unless in writing and duly signed by both you and us. This agreement is binding on our and your successors,
heirs, assigns, executors, and personal representatives.
____ 8. The Humane Society of the
Palouse, Inc has a seven-day health guarantee on all cats adopted from our
shelter. You must contact the shelter
before receiving veterinary care. You
must take your new pet to the veterinary hospital used by the Humane Society of
the Palouse to have any medical bills paid for.
____ 9. The Humane
Society of the Palouse, Inc retains ownership rights during the seven-day
foster period. Therefore, any medical
decisions in regards to this animal must be cleared by shelter staff and the
clinic used by the Humane Society of the Palouse.
____ 10. I have read this entire section and have had it explained to me and I completely understand and accept the rights and obligations involved. I hereby acknowledge receipt of the above-described animal and understand that it is not a selling price but a donation in exchange for medical and husbandry services provided by HSOP.
BY
SIGNING BELOW, I ACKNOWLEDGE THAT I HAVE READ AND UNDERSTOOD THIS CONTRACT AND
AGREE TO COMPLY WITH ALL CONTRACT PROVISIONS. I HAVE RECEIVED A COPY OF THIS
CONTRACT FOR MY RECORDS.
Signature(s)______________________________________________
date:__________
Approved
by Staff:________________________________________ date: _________