Alaska Dog & Puppy Rescue

P.O. Box 876888 907-745-7030 adpr03@yahoo.com

Wasilla, AK 99687 www.adoptafriend.net/akdogrescue.html

Adoption Agreement

Adopter’s Name:______________________________ Date:_____________

Physical Address:________________________________________________

City:_________________________ State:__________ Zip Code:_________

Mailing Address:________________________________________________

E-mail address:_________________________________________________

Home Phone:____________Cell #: ______________ Work #: __________

DL#:_____________________ Date of Birth: _____________________

Animal’s Name:_______________________ Intake #:__________________

Age_____ DOB_________ Sex:___ Date Altered: __________

Breeds:_________________________ Size Group: Toy Sml Med L XL

Color & Coat Description:_________________________________________

Microchip #:________________________ Rabies #:__________________

Adoption Fee:______________________ CASH ONLY

I hereby acknowledge receipt from “Alaska Dog & Puppy Rescue” (ADPR), the animal described above. I understand that ADPR makes no warranty regarding the animal’s disposition or health, and can give me only information received when the animal was relinquished or what was observed during the animal's stay with ADPR’s foster families.

ADPR offers a ten-day trial period. If for any reason during the first ten days from the date this form is signed, you need to return the animal, we will mail you a refund of 50% for puppies under 4 months of age or a full refund minus a $10.00 processing fee for any dog or puppy ages 4 months or over. After the ten day trial period, no refunds will be given on returned animals.

I agree to keep the animal current on all vaccinations and be responsible for any veterinary treatment the animal may require. I agree to keep the animal for its entire lifetime. If extenuating circumstances develop and I am unable to keep the animal, I will contact ADPR for placement assistance.

UNDER NO CIRCUMSTANCES WILL I TAKE THE ANIMAL TO ANY ANIMAL CONTROL FACILITY.

I agree to be personally responsible for the humane care, restraint, and control of the animal. If I fail to adhere to these terms, I agree to allow ADPR to reclaim the animal.

ADPR reserves the right to adopt out dogs and puppies at our discretion.

Adopter Signature:_________________________ Date:_______________

Foster Family :______________________ Processed By: ______________