Wigglebutt Rescue Adoption Application and Contract

Congratulations for wanting to adopt a pet in need. Please Note:

1) We reserve the right to perform a home visit

2) We reserve the right to approve or deny any adoption for any reason and the right to not disclose the reason

3) You must be at least 21 years of age to apply, if you live at home, a parent must complete application

4) The application is good for 1 year from the approval date

5) We offer no guarantee on breed, health, mental disposition on any adopted pets.

6) Once adoption is complete there are NO REFUNDS for any reason. You are responsible for the new pet in its entirety.

When answer choices are offered, please check all that apply. Please be as specific as you can.

Any item marked with a red asterik (*) is REQUIRED.

Your Information

First Name *

Last Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Phone Number *

Email Address (a copy of this form will be sent to the address specified here) *

Your Occupation *

Employer's Name and Address *

Name of Pet you are interested in Adopting *

General Terms & Conditions

Please check the box next to each of the following Terms and Conditions to indicate that you have read, understand, and agree with the item: *

1. Altering animals ears or tail is NOT ALLOWED in any way! The pet WILL be reclaimed.

2. Verification of fixing pup must be sent to WiggleButt Rescue by the time pup is 5 months old. *If pup/dog over 6 months old is not fixed at time of adoption the adopter must have done within 2 weeks and email Wigglebutt Rescue proof. (Our adopters are now entitled to be able to participate in the New Jersey low cost spay\neuter program. 20$ at participating vets offices.)

3. All Adoption Fees are DONATIONS being made to a 501c3 non-profit organization, are tax deductible, and non-refunable.

4. If your dog’s expenses are covered by the adoption fee, the remainder of the fee goes to assist other dogs in our care. Your adoption contribution pays for food, medical care and daily needs. Some of the lifesaving costs your contribution covers are: Emergency transport to pull euthanasia list dogs, spaying and neutering, vaccinations, medical care, supplies and food.

5. ADOPTION FEES ARE GENERALLY AS FOLLOWS: DOGS AND PUPPIES UNDER 1 YEAR OF AGE-$450-and up. DOGS 1-5 YEARS OF AGE-$380; DOGS OVER 5-7 YEARS OF AGE-$250; DOGS 7 OR OLDER-$150; Each animal may differ in fee from the above.

Wigglebutt Rescue AGREES TO DO THE FOLLOWING:

1. Give the Adopter title to, possession and control of the dog as described: For so long as the ADOPTER complies with the terms of this contract.
2. Provide ADOPTER with any and all veterinary records available for dog along with current medications.
3. Wigglebutt Rescue acknowledges receipt from ADOPTER of a donation as noted below to aid with reimbursement of expenses incurred to consider dog for adoption.

About your Household

Names of and age of residents in the house: *

Does anyone in the house have animal allergies? *

Do you Own or Rent your home? *

How long have you lived at this address? *

What plans do you have for this dog if you move? *

Do you have a yard? Do you have a fence? If yes how high? *

Have you owned any PETS in the past 5 years you no longer own? *

Do you currently own any PETS? (Please enter breed and age) *

Are there any other animals the dog will interact with? *

Are your other pets spayed or neutered? If not, why? *

Have you ever released a pet to an animal shelter or given away an animal? If yes, what were the circumstances? *

Have you ever had a dog euthanized for any reason other than old age? If yes, what were the circumstances? *

Will you keep your dog on heartworm preventative year-round forever? *

Do you agree to return the PET you are adopting to this rescue if you cannot keep it? *

References

Please notify your references that we will be calling, many references require permission from the applicant to release information

IN RETURN, THE ADOPTER AGREES TO THE FOLLOWING: *

Vet you will use (name, address, phone): *

3 Personal References (Name, Address, Phone) *

Being Perfectly Clear

Do you understand that if all conditions of the adoption contract are not met our volunteers have the right to remove the dog from your home without notice? *

Do you understand this is NOT REFUNDABLE from TIME OF POSSESSION OF ANIMAL? And "Animal "as is" WE Give NO Guarantees on Health, Breed or Mental dispositions of pet? *

Are you aware of, and agree to the contractual requirements? *

Sign Here

By Signing below, I acknowledge that I have read and understand the Terms and Conditions, and all Contractual Requirements of this document: *

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