ADOPTION CONTRACT #:
________________ DATE: ______________
____________ SEX: _____________
_____________ HW TEST: _________ FECAL:
WORMING: ___________ DUE: _____________
DATE OF LAST VACCINATIONS: DHLP: ________________ PARVO:
__________________________ RABIES TAG #: ____________________________ STATE: __________________
In consideration of the Akita Rescue
of Western New York, Inc. (ARWNY) allowing me (us) to adopt the above mentioned
Akita as our pet in accordance with ARWNY conditions, I (we), the undersigned,
agree to all of the following terms of this contract and understand that noncompliance with the terms of this agreement or falsification of the
application gives ARWNY
the right to reclaim this Akita through whatever means
necessary without refund of the adoption donation.
give Akita _____________ weeks to adjust to new surroundings.
return Akita only to ARWNY if unable to keep, at adopter’s expense.
never take this Akita to an animal shelter, pound, or humane society.
never allow this Akita to be used in animal research.
never allow this Akita to be used in DOG FIGHTING.
never allow this Akita to be used for protection training of any kind.
treat this Akita as a family pet, with affection and kindness and never subject
to abuse or cruelty at any time.
never leave this Akita alone chained or tied up, either indoors or outdoors
under any circumstances.
This Akita must be leashed unless in a secure, fenced yard. Due to the inherent temperament of the Akita, dog parks are not an acceptable place to
allow this Akita off leash.
treat the Akita as a house pet, and not kept outdoors all the time.
provide this Akita with shelter from sun and bad weather, a fenced yard or
enclosure, and clean water when outdoors.
maintain this Akita for the rest of its natural life on a high-quality food,
preferably all natural and soy-free, or as otherwise directed by a veterinarian.
heartworm preventative (no Ivermectin; Interceptor
genetic / hereditary
this Akita die from unknown causes, the adopter is requested to have the dog autopsied at the adopter’s expense and provide results to ARWNY in order to
help the breed.
immediately license, put and keep personal/rescue I.D. tags on this Akita at all times,
with a strong collar, preferably a rolled leather one.
notify ARWNY if I move and give my new address and home telephone number.
this Akita is lost or stolen, to notify ARWNY immediately by telephone and to
make every effort to locate the dog, including placing ads in local papers and
regularly checking all local pounds and shelters by telephone and in person.
adopter agrees to allow representatives of ARWNY to periodically visit and check
on this Akita to be assured of compliance with all of the items in this
adopter agrees to pay a suggested _____________ Adoption Donation upon receipt of this Akita. This is refundable during the adjustment period upon return of this Akita, but
at no time thereafter.
adopter agrees to pay a minimum of $30.00 handling charge to ARWNY on all
adopter agrees to be responsible for any and all legal fees incurred if a
violation of this contract results in a legal action.
adopter and Akita Rescue agree that the actual value of the Akita is $600.00.
AKITA RESCUE does not usually recommend that
an Akita of more than one year of age be adopted into a home where there are
children of less than teenage years. This recommendation is based on ARWNY’s
The Akita is known to be aggressive to other
dogs, especially dogs of the same sex, and is known to be aggressive to cats and
The Akita displays primitive canine behavior
patterns at times. When given harsh correction, the Akita may respond to
interpreted aggression with aggression.
The adopter has read and understood the
Information Package given to him/her detailing health and behavior
characteristics in the Akita breed.
ADDITIONAL CONDITIONS FOR ADOPTION:
The undersigned adopter has been advised of
these facts and agrees to accept all responsibility for the behavior of the
Akita chosen for adoption, and agrees to ALL CONDITIONS of this contract.
RELEASE OF LIABILITY AND INDEMNIFICATION:
In consideration of ARWNY allowing me/us to
adopt this Akita as our pet, I/we promise and agree to be solely responsible for
this animal and to indemnify and hold harmless the AKITA RESCUE,its Board of
Directors, Officers, Agents, Members, and Volunteers from any and all claims of
liability for the conduct of this Akita on or after the date of this adoption.
The undersigned (s) further agree
(s) and intend (s) that this RELEASE OF LIABILITY AND
INDEMNIFICATION shall apply to all
known, unknown, and unanticipated damages resulting
from my/our adoption,
ownership, or control of such animal.
THIS IS A BINDING CONTRACT ENFORCEABLE BY LAW.
Signature of adopter (s):
Signature of adopter (s):
State: ______________________ Zip Code____________
Driver's License Number & State:
Signature of ARWNY representative:
Additional Waivers/Stipulations by ARWNY:
ARWNY representative initials:______________ Adopter (s) initials: _____________