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ADOPTION CONTRACT #:
________________ DATE: ______________
AKITA’S NAME:
_______________________________________________________________
AGE:
_______________ SEX: __________________
COLOR/MARKINGS:
___________________________________________________________
SPAYED/NEUTERED:
_____________
HW TEST: _____________ FECAL:
_____
WORMING:
_____________
DUE: _____________
DATE OF LAST VACCINATIONS: DHLP: __________ PARVO:
__________ RABIES:
______
TATTOO
#:
_______________ 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.
1.
To
give Akita _____________ weeks to adjust to new surroundings.
2.
To
return Akita only to ARWNY if unable to keep, at adopter’s expense.
3.
To
never take this Akita to an animal shelter, pound, or humane society.
4.
To
never allow this Akita to be used in animal research.
5.
To
never allow this Akita to be used in DOG FIGHTING.
6.
To
never allow this Akita to be used for protection training of any kind.
7.To
treat this Akita as a family pet, with affection and kindness and never subject
this Akita
to abuse or cruelty at any time.
8.
To
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.
9.
To
treat the Akita as a house pet, and not kept outdoors all the time.
10.
To
provide this Akita with shelter from sun and bad weather, a fenced yard or
enclosure,
and clean water when outdoors.
11.
To
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.
12.
The
dog
has
been
fully
vet
checked
and/or
wormed
prior
to
adoption.
Once
adopted,
the
new
owner is
responsible
for
all
ordinary
and
extraordinary
vet
care.
The
adopter
agrees
to
provide
regular veterinarian
care
when
necessary,
including
annual
vaccinations,
parasite
checks,
dental
care, and
to
maintain
this
Akita
on
heartworm preventative
(no Ivermectin; Interceptor
okay).
If
this
is
not
done,
ARWNY
reserves
the
right
to
reclaim
the
dog.
13.
ARWNY
will
fully
disclose
any
known
health
problems
prior
to
adoption.
ARWNY
is
not
responsible
for any
genetic/hereditary
defects
evident
after
adoption.
14.
Should
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.
15.
To
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.
16.
To
notify ARWNY if I move and give my new address and home telephone number.
17.
If
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.
18.
The
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
contract.
19.
The
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.
20.
The
adopter agrees to pay a minimum of $30.00 handling charge to ARWNY on all
returned
checks.
21.
The
adopter agrees to be responsible for any and all legal fees incurred if a
violation of this
contract results in a legal action.
22.
The
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
past experience.
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
other animals.
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):
_________________________________________________________
Name (s):____________________________________________
Name (s):____________________________________________
Street address:
_________________________________________________________
City: __________________________________________________________________
State: _____________________________________________Zip Code______________
Driver's License Number & State:
_____________________________________________
Home Telephone:
_________________________________________________________
Work Telephone:
_________________________________________________________
Signature of ARWNY representative:
_____________________________
Additional Waivers/Stipulations by ARWNY:
ARWNY representative initials:______________ Adopter (s) initials: _____________
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