Central Rescue & Rehab
P.O. Box 79, Wales, MA
01081
info@centralrescue.org www.centralrescue.org
TERMS OF ADOPTION
My signature below indicates that I am at least 21 years of age and intend to be the legal
owner and the person responsible for the care and well being of any dog I adopt from Central Rescue & Rehab. By signing this application,
I give representatives of Central Rescue & Rehab permission to contact my veterinarian, landlord, or other rescue groups/humane
societies for information to aid in the evaluation of whether a Central Rescue & Rehab dog is appropriate for me. I understand that any misrepresentation of the facts in this application will invalidate
the adoption agreement and give Central Rescue & Rehab the right to reclaim the dog without refund of the adoption fee.
Cost: The Central Rescue & Rehab adoption fee is non-refundable.
Medical: I understand that the dog has been given certain basic inoculations and other medical treatment for problems that
Central Rescue & Rehab is aware of and can treat before adoption. The dog
I am adopting is accepted by me “as is.” I agree to provide yearly
checkups, shots, and heartworm prevention. I understand that Central Rescue &
Rehab makes no representations or warranties regarding the current or future medical condition of the dog and is not responsible
for additional medical care for the dog. While most dogs are provided neutered or spayed, if I have adopted a dog that has
not been neutered or spayed, I agree to have the dog spayed or neutered within 60 days and send a copy of the certificate
to Central Rescue & Rehab, P.O. Box 79, Wales, MA 01081.
Temperament: I understand that the dog has not been evaluated in a home setting and that Central Rescue & Rehab makes no representations
or warranties regarding the dog’s behavior with adults, children, or other animals, or provides other guarantees as
to the dog’s characteristics, personality or training. I understand and
agree that Central Rescue & Rehab is not responsible for any injuries or property damage resulting from the possession
or ownership of this dog.
Care: As this dog’s new owner, I agree to provide the training required to ensure a secure and respectful
dog/owner relationship. I will not let the dog run free without supervision, be chained out all day or all night, be allowed
around children under 14 years of age without adult supervision, or be allowed to ride loose in the back of a truck, or remain
unattended in any vehicle in extreme temperatures (over 70 degrees Fahrenheit). I
will license the dog in the town I live in and tag the dog for identification purposes.
Adoption Termination: If, for any reason, the adoption is not satisfactory for the dog or adoptive owner, Central Rescue & Rehab requires
that the dog be returned, at the adoptive owner’s expense, to Central Rescue & Rehab. The dog may not be sold or given to a new owner without Central
Rescue & Rehab prior written approval. Central Rescue & Rehab reserves
the right to take back this dog if it is ever neglected, abused or improperly cared for.
I agree to relinquish custody immediately upon request without the need for further legal writ or court order. I agree to promptly contact Central Rescue & Rehab if the dog is lost for more than 24 hours.
I, on behalf of myself and all persons resident in the household where _____________ [dog’s
name] will reside, hereby accept possession of title to _____________ [dog’s name] and responsibility for the animal
identified above and hereby release, indemnify and discharge Central Rescue & Rehab, and its directors, officers, employees
and agents, forever from and against any liability for any injury or damage to any person or property caused in the future
by this adoption, or by said dog, and from and against any causes of actions, suits or demands whatsoever that may arise as
a result of such injury or damage.
Adopter: to be signed at time of adoption
For Central Rescue & Rehab:
Date: _________________________________Date:
_______________
Name (please Print)_______________________ Name: _______________
Signature _______________________________Signature: ______