Homeward Bound Pet Rescue & Referral, Inc.
1589 Placer Drive
Fairbanks, AK 99712
Name of Dog: ___________________________
Sex: M F Age: ____ Breed: ____________________ Color: ______________
Upon release of this dog to me, I will do the following:
Provide him/her with kind and humane/loving treatment at all times.
Provide proper and sufficient food, water, shelter at all times, and identification when outside.
Provide him/her with proper veterinary care, including, but not limited to, timely immunizations.
I agree that this dog is to live indoors (not meaning in the garage or basement, or the likes thereof) and to be outside only for periods of play/exercise and potty time. If circumstances change and I feel that this dog can no longer live indoors, s/he is to be returned to Homeward Bound Pet Rescue & Referral, Inc. If the dog is not returned to Homeward Bound Pet Rescue & Referral, Inc. ,(hereinafter referred to as “HBPR&R”) and/or it comes to HBPR&R’s attention that the dog is being left outside for prolonged periods of time, especially in extreme weather conditions, I agree that ownership of the dog immediately reverts to HBPR&R and I hereby give permission to HBPR&R to remove the dog from my property without notifying me and without my knowledge. In an extreme situation such as this, I would be notified after the fact by HBPR&R that the dog was removed and is safe.
Provide him/her with daily exercise, and a fenced yard, if possible. I have been informed by HBPR&R that a fenced yard is preferable.
Comply with all state statutes and local ordinances governing the licensing and ownership of dogs. If unfamiliar with those statutes and/or ordinances, I will familiarize myself with them.
If for any reason I am unable to keep the dog, I will not, under any circumstances, abandon him/her or place him/her in another home, but will contact HBPR&R at 457-6783 immediately so that proper arrangements can be made for its return to the Rescue Program.
If behavior problems arise, to make all attempts to relieve the problem through professional advice and proper training; including notifying HBPR&R of the problem, seeking possible solutions; and
Upon transfer of ownership of the dog to me, I shall donate a $250.00 adoption fee to help defray medical costs and care for the dog. This Adoption fee is refundable, in full, within ____ days of adoption upon return of the dog to HBPR&R.
I accept the dog as-is and assume all risk and financial responsibilities of ownership. I release HBPR&R, its officers and assigns, any previous owner, foster home, and Fairbanks North Star Borough Animal Control from any and all liability associated with any illness of the dog, or damage or injury hereafter caused by the dog. I agree to return this dog to HBPR&R, making no charges of any nature for licensing, care, food, or other services or items if for any reason I am unable to properly care for or keep this dog. I agree to pay any reasonable attorney’s fees and court expenses if HBPR&R must bring legal action against me to enforce this Adoption Agreement. I understand that any sum of money I have donated to HBPR&R is to be used in caring for dogs in the rescue program and is not refundable (except as specifically outlined in 9 above).
Signed: ______________________________________ Date:__________________________
Printed Name: ___________________________________________________________________
City, State, Zip:___________________________________________________________________
Telephone, Fax:_________________________________ Email:____________________________