Download PDF Version of our Adoption Agreement


Adopted Animal Description

Pets Name: ____________________ Breed: _______________________________ Age/DOB: ________________ Sex: _______Spayed/Neutered (Y/N)____________ Date of Castration:_____________________

Color/Description: ____________________________________________________ Name of Veterinarian: _______________ Phone Number:_____________________

Vet Address:______________________________________________________ Date of last vaccinations and health checks:

Heartworm Treatment (Y/N): ______ Date: __________ Vaccine (Y/N)_______ Date__________

Known health conditions/treatments or other comments: ________________________________________________________________________________________________________________________________

I, (NAME) ________________________________________, hereafter referred to as the adopter, hereby agree that the above described animal is being adopted by me solely as a pet for myself and/or my immediate family. I agree that I will not sell, give away or otherwise dispose of said animal to any person(s), for any reason. If at a later date I am unable or unwilling to keep this pet, I agree to first contact CHARLENE PENNEY AT HelpAWS and give her the option to reclaim said pet at no charge.

I hereby agree to care for the above-described pet in a humane and responsible manner and to provide it with clean and adequate shelter, food, water and veterinary care. I further agree that said pet shall reside inside my home/yard and shall not be allowed to roam freely. I hereby agree that this pet shall wear a collar or harness at all times.

I hereby agree that the adoption fee of $ _________ helps to cover the Spay/Neuter expense of the animal. If not already done, I agree to allow HelpAWS to take the animal on (date) ____/____ to have the animal spayed/neutered. Failure to comply with this requirement will result in the immediate return of the animal to HelpAWS

I hereby understand and agree that the current owner makes no representations or warranties, expressed or implied, about the above mentioned animal’s temperament and is hereby absolved from any liability for future damages or injuries caused by said animal. I also understand and agree that the current owner further gives no guarantees, expressed or implied, of the suitability of the animal to the adopter and/or his family.

Adopter’s Name: ______________________________________________

Address________________________________Town______________________Phone Number___________________________

I certify that all statements made by me on this adoption agreement are true and correct. I agree that the current owner has the right to confiscate the above described animal in the event that any statements made by me are found to be false and/or my check for the adoption fee is returned for insufficient funds.

Adopter’s Signature_______________________ Date______/______/______

Witness Signature____________________________


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Current owner is defined here as HelpAWS who originally held the above described animal in t[1]heir possession. Adopter is defined here as the person who accepts for adoption the above described animal.

Download PDF Version of our Adoption Agreement