Adoption Agreement

This Agreement is made and entered into on this _______ day of ____________, 200__, by and between the Cocker Spaniel Adoption Center, Inc. (CSAC) and the following individual(s), hereinafter "Adopter":

Name: ______________________________________

Home Address: ________________________________

City, State, Zip: ________________________________

Business Address: ______________________________

City, State, Zip: ________________________________

E-Mail Address: ________________________________

Home Phone: __________________________________

Cell Phone: ___________________________________

Work Phone: __________________________________

WHEREAS Adopter expressly wishes to adopt the following dog, known as and particularly described as follows:

Name _______________________________

Color _______________________________

Breed _______________________________

Sex _________________________________

Age _________________________________

Altered _______________________________

Now, therefore, for good and valuable consideration, and in further consideration for the mutual promises made herein, the parties agree as follows:

Adopter will pay a fee of $250 for each dog adopted under the age of eight years. The fee for dogs eight years and older is $200. Please indicate the amount of your fee: _____________.

This fee shall be used to help CSAC offset the large expenses incurred in rescuing, boarding, and caring for these dogs.
All dogs placed for adoption have been examined by a certified veterinarian. If the dog's previous health records have been given by a previous owner, CSAC will provide these records to Adopter. CSAC attempts to contact the dog's past veterinarians, but sometimes contact cannot be made. Even when it is made, CSAC cannot assure the completeness or accuracy of the veterinary records.
Adopter shall immediately provide the dog with a comfortable and safe leash and collar, including a sturdy and securely connected identification tag, bearing Adopter's name and phone number in readable script. Adopter shall not allow the dog outdoors without proper identification on the dog at all times.
Adopter shall not transfer, sell, give, or in any way change custody of the dog from Adopter to any other person or entity. If Adopter no longer wants or cannot keep the dog, Adopter must return the dog to CSAC.
If the dog is no longer wanted or can no longer be kept, and this is a long distance adoption, or Adopter has moved a long distance from CSAC following the adoption (in both cases more than 50 miles from the place of adoption), Adopter assumes sole responsibility and expense for returning the dog promptly and safely to CSAC. Adopter shall immediately notify CSAC of Adopter's intent to give up the dog.
ADOPTER'S INITIALS: _____.
If adopting a puppy, and it is too early to spay or neuter, Adopter agrees to spay or neuter the puppy no later than the following date: ________________.
ADOPTER'S INITIALS:______.
If the dog is lost, stolen or dies, Adopter shall immediately notify CSAC.
Adopter will not allow the dog to be used for medical or experimental purposes.
Adopter will not leave the dog in the care of an individual or individuals who by age and/or mental capacity are not capable of responsibly attending to the dog.
Adopter shall treat the dog humanely, particularly with respect to the provision of adequate food, water and shelter. Adopter never will physically or emotionally abuse the dog, nor will Adopter let any other person or animal physically or emotionally abuse the dog.
Adopter will never leave the dog unattended in a car.
Adopter shall not keep the dog outdoors for extended periods of time, always considering the weather and the dog's general health and safety. It is clearly understood that the dog is an indoor companion. Inside housing is to be provided at all times; at no time will the dog be kept outdoors.

Adopter shall not chain or tie the dog for an unreasonable period of time (in excess of one hour; less if weather is hot, cold or inclement), and never without abundant moving space and responsible human supervision at all times. Dog shall never be left outdoors without responsible human supervision.
Adopter shall provide routine and emergency veterinary care as needed. Booster vaccinations shall be administered at least once per year with a routine examination.
The dog is being adopted as a companion only. Adopter shall not use the dog for guarding, protection, or breeding purposes.
CSAC may make inquiries about and/or examine the dog at any time, upon reasonable notice to Adopter. Adopter shall not withhold from CSAC access to the dog or the dog's medical records. Adopter shall promptly respond to any CSAC concerns about the status and condition of the dog.
If Adopter resides in housing which is rented, Adopter shall obtain permission from the landlord prior to the dog's placement with Adopter. A copy of the lease approving pets in the rental housing will be acceptable.
Adopter understands that adopted dogs typically will require time to adjust to their new homes and surroundings. This includes attitude and housebreaking adjustments. Adopter acknowledges receipt of Instructions about Adopted Dogs and agrees to follow the instructions provided in that document.
Adopter will notify CSAC of any change of address or location where the dog is being kept.
In the event that CSAC determines, in its sole discretion, that Adopter is not providing adequate food, shelter, veterinary care or is otherwise in breach of any of its obligations herein, CSAC shall be entitled to take back the dog and make appropriate arrangements for the dog's care and/or readoption. Should such an event occur, the donation made by Adopter shall be forfeited.
It is expressly understood by and between the parties that CSAC makes no representations or warranties about the dog whatsoever, including the following:

-- Health, temperament, intelligence or compatibility with any other person(s), animals(s) or thing(s).

-- The dog's ability to reasonably adjust to Adopter's home.

-- Previous ownership of the dog.
It is expressly understood by and between the parties that CSAC may have little or no information or records for the dog or about the dog's history. Adopter agrees to adopt the dog although little or no information has been provided to Adopter. Adopter expressly understands that the dog is adopted AS IS.
Adopter shall not hold CSAC liable or responsible for any medical care or treatment for the dog.
Adopter expressly agrees to indemnify and hold harmless CSAC and any of its agents, representatives and volunteers for and against any and all manner of actions and causes of actions, suits, debts, dues, accounts, bonds, covenants, agreements, judgments, claims, and demands whatsoever arising from or relating to the adoption, placement and/or possession of the dog.
Adopter expressly agrees to indemnify and hold harmless CSAC and any of its agents, representatives and volunteers for and against any and all damage and/or injury caused by the dog to any other person(s), animal(s) or thing(s).

Please complete the following information for our records:

Our Adoption Application was reviewed and approved by:

___________________________________

on the following date: ___________________

Our Vet Check was completed and approved by:

____________________________________

on the following date: ____________________

Our Home Visit was completed and approved by:

______________________________________

on the following date: ______________________

___________________________ was fostered by:
Dog�s Name

_______________________________________

Are there any addendums or stipulations to this agreement? ___Yes ____ No

If yes, please explain:

If yes, signed forms must be included with the Agreement.

This is a legally binding contract. No provisions of this contract may be altered, modified or in any way changed unless the same be in writing. This contract contains the entire agreement by and between the parties.

I have read and fully understand this contract, and I agree to fully abide by all the conditions, promises, terms and covenants I have made.

If more than one adult, age 18 or older (spouses, partners, significant others, parents living with adult children, siblings, friends, house mates) is adopting the dog, all adults involved must sign the Adoption Agreement.

Adopter's Signature: _____________________________

Adopter's Name: ________________________________

Adopter's Signature: _____________________________

Adopter's Name: ________________________________

CSAC Authorized Representative's Name:

_____________________________________________

CSAC Authorized Representative's Signature:

____________________________________________