Adopt a Dog

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Are there other pets in the home? If yes, explain: *

By entering my initials below, I understand that any information shared by the dog's former owner or foster's experience about this dog during vetting and time with A Pass for Paws makes no warranties of any kind concerning the dog's future disposition. I understand the risks involved in adopting a rescue dog and assume that risk with a smile and heart of love. *

Spouse/Partner's name (if applicable):

Phone

Your Name: *

Adoption Contract

HAVE YOU OR ANYONE IN YOUR HOUSEHOLD BEEN CONVICTED OF ANIMAL CRUELTY, NEGLECT, OR ABANDONMENT? *

Yes

Spouse/Partner's date of birth (if applicable):

DECLARATION: By entering my full name and clicking submit, I certify that all information provided on this form is true and correct. I give persmission to Shelly Summers and her agents acting on her behalf to verify information as needed. I understand that a home check is mandatory prior to adopting a dog. Any false statement will terminate all potential adoptions. *

Spouse/Partner's drivers license state & number (if applicable):

If no, please explain:

Name of dog you are adopting: *

I, the aforementioned adopter, by entering my initials below, agree to provide care from this day forward to my new dog. The dog will be kept in the house and will not be tethered outside. *

Is your yard fenced? Describe: *

By entering my initials below, I agree that all expenses incurred after I take possession of the dog will be my sole responsibility, and A Pass for Paws is released of any and all liabilities whether financially or otherwise. I understand that A Pass for Paws has obtained this dog as a rescue and may have no prior information regarding age, breed, health issues, training, and background. *

What is the best time and day to arrange a home check? *

Is this where the dog will live? *

Are your other pets spayed or neutered? (select NA if no other pets) *

Yes NA

“Saving one dog will not change the world, but surely for that one dog, the world will change forever.”-Karen Davison

Today's date: *

Home Address: *

Date of Birth: *

Drivers License State & Number: *

By entering my initials below, I agree to never sell, trade, or surrender the dog to any person or agency without giving prior notice to A Pass for Paws. I agree that A PASS FOR PAWS WILL HAVE THE FIRST CHOICE OF RECLAIMING THE DOG. I agree that the adoption fee is non-refundable and there is no reimbursement if the adoption does not work out. *

Are your other pets up to date on vaccinations? (select NA if no other pets) *

Yes NA

If yes, please explain:

Veterinarian's Name, Office Name, Address, and Phone Number