Adoption Application

Following in the adoption application and agreement all potential adopters must fill out before they will be allowed to visit with or take home a dog from our shelter house facility.  If you haven't done so already, please read about our adoptions process before filling out an application and signing the agreement.

Check This Box so we know you're filling out an adoption application.

Are you 21 years old or older?  ---- Yes No  

If you answered "NO", STOP.  You cannot adopt from us.  This application includes a binding legal agreement, and if you are not of legal age, you cannot sign the agreement.

This application contains a binding legal agreement, and is used as a screening tool to help us match dogs with adopters.  Read the entire application, provide us with complete answers, and ask any questions you may have about this dog or our adoptions process before you sign this form.  The potential adopter understands that signing this agreement alone does not guarantee that he/she will be able to adopt the dog, or that he/she is obligated to adopt the dog.  An “Adoption” is not finalized until the adoption has been approved, all fees have been paid in full, and the dog has been turned over to the adopter. 

FILL OUT THE ENTIRE FORM.  Some of the questions may seem redundant, but we need you to answer every one.  If there are things that do not apply to you or your home enter "N/A" for "not applicable".  When you have filled in all of the fields, click on the SUBMIT button at the bottom of the application and agreement only once.  If you have filled out the form correctly, it will be forwarded to our e-mail box within 24 hours.  If you have problems with this form and prefer to fill out a document in the Microsoft WORD or PDF format, please e-mail us, and we'll send you one. 

What is the name of the dog you would like to adopt?

What is the dog's ID Number (if you know it)?

How did you find out about our adoptable dogs?

---- Saw in Shelter House Fetch 11 Staff Saw it on TV Newspaper Telephone Book Adoption Fair Petfinder.com Pets911.com 1-800-Save-a-Dog.com Next Day Pets.com PetHarbor.com Craigslist Freecycle.org Veterinarian Referral Another Shelter, Pound or Rescue Family / Friend Other

Please provide the following contact information:

Tell us about your family (how many adults, how many children, what you like to do as a family):

Tell us about your house (square footage, how many rooms, rent or own, house or apartment, etc.):

Tell us about your yard (fencing, acreage, etc.)

RENTERS:

Can you supply us with a copy of your rental agreement or a note from your landlord stating that it's all right for you to have a dog on the property?

---- Yes No Not Applicable

 

If you are a renter, we will need your landlord's contact information:

Landlord's Name:
Mailing Address:
City:
State:
Zip:
Telephone:
Fax:
E-Mail:

IN THE NEXT 6 MONTHS:

Are you planning to move within the next 6 months?

--- Yes No Unsure

Are you planning to have a baby within the next 6 months?

--- Yes No Unsure

Are you going to be starting a new job or school within the next 6 months?

--- Yes No Unsure

If you answered "YES" to any of the above three questions, we suggest that you reconsider adopting a dog at this time.  If you are anticipating a move, will you be able to take the dog with you?  If you are planning on having a baby, do you know how to train the dog to accept the newborn?  If you are going to be starting a new job or new school, will you have the time to properly train and socialize the adopted dog?  Shelter dogs often come out of uncommitted, stressful, and/or impermanent situations, and we don't want to put them right back into one.  What "stresses you out", will stress them out as well.

IS THIS DOG GOING TO BE A GIFT:

Is this dog going to be adopted as a gift for a child?

---- Yes, Child Under 5 Yes, Child 6 to 12 Yes, Child 13 to 17 No

If you answered "YES" to the above question, who will provide the dog and child with the supervision they will need to be safe together?  And who will tend to the dog if the child is unable or unwilling to do so?  (If the answer was "No", enter "not applicable" in this field.

OTHER QUESTIONS:

Have you ever adopted a dog before?  If "YES" tell us about that adoption and if the dog is still with you.

Where will the adopted dog sleep?

How many hours during the day will the dog be left alone?

---- 0 or Only Very Rarely 1 to 4 Hours a Day 5 to 9 Hours a Day More than 9 Hours a Day

NOTE: If you are applying to adopt a puppy, keep in mind that young pups that spend a lot of time alone at home do not get the training, human contact and socialization they need to be good companions and doggie citizens.  Isolated pups usually grow up either very fearful of anything or anyone new, or become very aggressive because they never learned how to cope with the "unknown".  Also keep in mind that crate training doesn't work on puppies that are younger than 4 months old, because before that time most puppies have no conscious control of their bowels or bladders.  Generally, a young pup should never be left alone or crated for more than 2 hours at a time.  If you cannot stay home with the puppy to give it the training and socialization it needs, it is best not to adopt one.  Go for an older dog that can manage "alone time" better.

When the dog is left alone, where will it be kept?

Tell us about your skills / experience with housing and training dogs.  [Check all that apply.]

Basic Obedience Training
Leash Training
House-Training
Crate-Training
Clicker Training
Dog Grooming
Breeding Dogs
Pregnancy and Whelping
Tricks and Games
Agility
Rally-O
Hunting
Retrieving
Therapy Dogs
Fearful Dogs
Special Needs Dogs

OTHER PETS:
 

Are there currently other dogs on your property (whether you own them or not)? If  "YES" tell us the dogs' names, breed, genders, and ages.

Tell us how your existing dog(s) may react to a new dog in the home:

 

Are your dogs spayed/neutered?

---- Yes No I am not sure

 

Are your dogs current on their vaccinations (DHLPP and Rabies)?

---- Yes No I am not sure

 

Are your dogs current on their licenses?

---- Yes No I am not sure N/A Where I live

 

Are your dogs free of parasites (worms, ticks, fleas, etc)?

---- Yes No I am not sure

 

Has any dog died of Parvo on your property within the last 6 months?

---- Yes No I am not sure

 

Do any of your dogs have heartworms?

---- Yes No I am not sure

 

Are your dogs on heartworm preventative?

---- Yes No, we do not have a problem with heartworms in my area No, I do not believe in medicating dogs unless they need it No, it is too expensive I am not sure

 

Do your dog have identification tags and/or microchips?

---- No Yes, an ID Tag on its collar Yes, a microchip Yes, both an ID Tag and a microchip

 

Tell us about any other pets or livestock there may be on your property:

Has a pet ever died in your care?  If "YES", tell us about the circumstances of the death.

HYPOTHETICAL SITUATIONS:  In this section of the application, we're looking for thoughtful answers.  Try to refrain from single-sentence answers or "I don't know" as a response.

You are driving home and accidentally hit a dog with your car.  What do you do?

Your adopted dog comes down with a case of diarrhea.  What do you do?

Your adopted dog snarls or snaps at a small child.  What do you do?

Your adopted dog seems fearful and won't come out from under the bed.  What do you do?

Your adopted dog howls during the first few nights it's with you.  What do you do?

REJECTIONS:

Sometimes we reject applicants because we don't think the dog they want to adopt is a good match for their home.  If your application is rejected, how will that make you feel?  NOTE: When you submit an application, we assume that you are submitting it with a specific dog in mind.  Sometimes you might be rejected as an adopter for that specific dog, but may be suited as an adopter for another dog.  If that's the case, we'll let you know.

ASK QUESTIONS:

If you have any questions you would like to ask us, please feel free to do so.  (We love potential adopters who ask questions!)

Now, before submitting this application, read the following agreement.

DOG ADOPTION AGREEMENT

This document is legal and binding, and provides Fetch 11 Humane Society and/or its designees certain rights even after the dog is adopted.  It is important that you provide accurate information throughout this document, and that you read the document carefully and understand its contents.  If you have any questions, please ask them. Signing this agreement alone DOES NOT guarantee that you will be allowed to adopt a dog from us, nor does it obligate you to adopt a dog.  An adoption is not finalized until this application and agreement have been approved by our staff, any applicable adoption fee has been paid, and the dog has been physically turned over to its adopter.

Part 1: Fetch 11 Humane Society (herein referred to as “the agency”):

• The Agency warrants that (1) the Agency is the legal owner of the dog; (2) the dog is free from all liens and encumbrances; (3) the Agency has the right to adopt out the dog; and (4) the Agency will warrant and defend the title of the dog against any and all claims and demands of all persons when the dog is adopted.

• The adopter (named in the application above) will receive from Fetch 11 Humane Society a form which includes data on the dog’s vaccinations and its veterinarian’s contact information.

• The Agency expressly disclaims all expressed or implied warranties as to the health, merchantability or fitness of this dog for any particular purpose.

• Adopters are eligible for short-term health insurance for their adopted dog through ShelterCare for the cost of $1.00. The policy is only good for about 30 days.  When that time period is over, if the adopter wishes to continue the insurance, the adopter will be required to pay the premium.  The adopter may otherwise allow the policy to lapse. Adopters must activate this policy immediately before or immediately after picking the dog up from the shelter in order to correctly activate the policy.   The policy can be activated by going online to www.sheltercare.com.

  • All claims made against the insurance policy must be made directly to the ShelterCare/PetCare Pet Insurance Program.  Claims may not be filed with Fetch 11 Humane Society.

• The agency will inform the adopter of any known health or behavior issues the dog may have prior to adoption.  Once the dog leaves our facility, its care is wholly the responsibility of the adopter. Fetch 11 Humane Society does not offer and is not obligated to provide any other health benefits, services or care for the adopted dog once the adoption is finalized.  The agency is not liable for any health or behavioral issues not known to us as the time adoption.

Part 2: The Adopter (as named on the application above):

• The adopter has read, understands, and agrees with the items listed under Part 1 of this document above. The adopter fully understands that Fetch 11 Humane Society makes no warranties or claims regarding this dog besides those stated above, and the adopter is accepting said dog “as is”.

• The adopter has read, understands, and agrees to the terms associated with adopting this dog as detailed on the Fetch 11 website.

• The adopter, has reviewed the documentation available on the above referenced dog, and/or has visited with the dog, and would like to accept the dog for adoption.

• The adopter will release this dog to Fetch 11 Humane Society if, at any time, the adopter is requested to do so by Fetch 11 Humane Society because of any real or suspected violations of the terms of this agreement, making no charge for the animal, the animal’s upkeep or any other sundries or “fees”.  Further, the adopter will return this animal to Fetch 11 Humane Society in the event that, at any time, the adopter feels that he/she cannot properly care for the animal.  In such cases the adopter will provide adequate transportation for the dog to the agency.

• The adopter understands that Fetch 11 Humane Society has a “no refunds” policy if the dog is adopted from us. If the dog is returned, the adopter forfeits all fees paid.

  • The only exception to this rule is if the adoption fees are paid in advance of pick-up and the dog becomes “unadoptable” due to injury, illness, or death.  In such circumstances, the adopter will be given the option of getting a full refund, adopting another suitable dog from our facility, or donating the adoption fee to Fetch 11.

• The adopter agrees to allow Fetch 11 Humane Society or its designees to visit his/her home at any time without prior notice, both before and after the adoption, to assure the condition of the dog and that the stipulations of this agreement are being upheld.

• The adopter agrees to indemnify and hold Fetch 11 Humane Society and its staff members harmless in the event of any illness(es) this dog may have, or for any damages this dog may inflict on any person or property once released into the adopter’s care by this agreement. (In other words, once the dog has been released to you, you are responsible and liable for anything it does.)

• The adopter accepts this dog into his/her home as a companion and pet, and will use it for no other purposes. (e.g., the adopter will not allow this dog to be used for any inhumane or experimental purposes.)

• The adopter will provide this dog with humane care, giving this dog ample food, water, shelter, veterinary care and exercise appropriate to the needs of its age and breed throughout its lifetime.

• The adopter will only employ humane discipline when dealing with this dog’s behaviors.

• The adopter will confine this dog only in a humane manner.

• The adopter will never transport this dog in the open bed of a truck and the adopter will never confine this dog to a locked or closed vehicle in the heat of summer or the cold or winter, even if it’s “just for a few minutes”.

• The adopter attests to the fact that neither the adopter, nor anyone in his/her household, or associated with his/her household, has ever been suspected of or convicted of animal abuse or neglect.

  • The adopter further agrees that if the adopter observes or suspects animal abuse in his/her community, the adopter will contact the authorities and report the abuse immediately.

• The adopter will have the dog properly licensed in his/her local community per the laws and regulations of said community.

• The adopter will allow Fetch 11 Humane Society to photograph, video tape and/or audio tape him/her and his/her adopted dog for use in the Fetch 11 Humane Society archive files, and/or for advertisement/training purposes and hereby relinquishes all rights to said photographs, videos tapes and/or audio tapes in perpetuity.

• The information on this form and the included “Application” is true and accurate.

• If the dog is not already spayed/neutered, the adopter agrees to have the dog altered within thirty (30) days of adoption and provide Fetch 11 Humane Society with proof of the same upon demand. 

  • An exception to this rule is if the dog adopted is a young puppy.  In this case the adopter will have until the puppy is 6 months old to get the puppy spayed/neutered.

  • Failure to comply with this spay/neuter agreement will result in prosecution of section 31762 of the Food and Agricultural Code: “Failure to comply with a spay/neutering agreement”, confiscation of the dog, a fine of $250 payable to Fetch 11, and/or the costs of any legal or other action that has to be taken by the agency against the adopter to secure the dog and have it properly altered.

• The adopter agrees that he/she will not permit this dog to run at large or become a public nuisance.

• The adopter understands that Fetch 11 Humane Society will not transport the dog to/from the adopter unless previously agreed to in writing, and that the adopter is responsible for picking up the dog at the appointed adoption date and time.

• Other stipulations mutually agreed to:

SIGNATURE AND SUBMISSION:

I the undersigned am typing in my name below, and I understand that by typing in my name below my name stands as my legal signature, and is as binding to this electronic application and agreement as an original signature on a hard copy of the application and agreement.  I understand that this application will not be accepted without a signature.

Type in Your Name:

Today's Date: 

Now, click on the SUBMIT button below to send this application and agreement to us. 

It is wise for you to print out a copy of this page (or the confirmation page when it pops up) for your reference.