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13311 S Cresap St.Cumberland, MD 21502240-979-6004ADOPTION APPLICATION AND AGREEMENTThe recipient agrees to abide by all county and state animal control laws. The recipient agrees to accept this animal as a pet and companion. To ensure proper care and treatment for the animal in our charge, we reserve the right to reclaim the animal if it is not being cared for in a manner acceptable to us, or found to be in violation of county or state animal control laws. The animal may have traits, health, or temperament issues unknown to us; the animal may become ill, and may bite. Heart of the Earth Sanctuary and Rescue will assume no liability as to the health or temperament of this animal. You will be provided with Vet records and will be made aware of any illness or challenges while in our care.All animals will be vetted, altered and up to date on all vaccines before being adopted out.All animals will be micro-chipped before adoption. This is included in the adoption fee. Where the microchips have a pre-paid lifetime registration, it is the responsibility of the adopter to complete the registration using the pamphlet that is provided, and update info to their personal information. Adopter also gets an ID tag for collar. If animals are adopted on site, the organization’s computer may be used to complete this action.The animal, if feline, must not be declawed or have a Tendonectomy for any purposes.The animal must not be forced to live outside, for any reason. We will only adopt our animals out to homes where the adopters agree that the animal will live inside with their new family. I, the undersigned, hereby declare that I am aware:That animals are different from humans in their response to human actions.That the actions of animals are often unpredictable.That animals should be closely supervised when they are with children.The Heart of the Earth Sanctuary and Rescue makes no claims or representations as to the temperament, health, or mental disposition of the animal put up for adoption.If it is found that the animal is living outside, it can be reclaimed by Heart of the Earth Sanctuary and Rescue without refund of adoption fees.A copy of this agreement will be sent to my vet. And that Heart of the Earth Sanctuary and Rescue has the right to call my vet at any time and check on the wellbeing of the animal.That should I need to rehome the animal, I must return it to the Heart of the Earth Sanctuary and Rescue without refund of adoption fees.I understand that Heart of the Earth Sanctuary and Rescue is able to do a home check.I hereby accept the possession and title of the animal identified below and hereby release and waive any right against the Heart of the Earth Sanctuary and Rescue which I may have now or in the future for damages to person or property caused by said animal. Adopter:________________________________________________ ID:______________________________________________Co-adopter:______________________________________________ ID:______________________________________________Address: _________________________________________________________________________________________________Home Phone:________________________________________ Cell/Other Phone:______________________________________Email Address: ____________________________________________________________________________________________Do you: ___ Own ___ Rent Landlord’s Name:__________________________________________________________________ Landlord’s Phone: _________________________________________ Signed letter of permission from Landlord: ___ Yes ___ NoIn my household there are (#): _____ other animals _____ children under 18 _____other adultsVeterinarian’s Name: _____________________________________________ Veterinarian’s Phone: _______________________List the TYPE (dog, cat, etc.), NAME, AGE, GENDER, and SPAY/NEUTER status of all animals you currently own:___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________Information on animal you wish to adoptAnimal’s name: ___________________________________________________________________________________________Type (e.g. cat): _________________________ Breed (e.g. domestic short-haired):______________________________________ Color:___________________________________________________________________ Gender ____________ Age _________Adoption Fee $_______________Cash ____________Check ____________Heart of the Earth Sanctuary and Rescue reserves the right to contact landlords, veterinarians, or any other parties included or referenced in this application for verification purposes. Heart of the Earth Sanctuary and Rescue reserves the right to decline any adoption at any time. Any fraudulent information provided could result in an adoption being rescinded and the animal removed from applicant's home without a refund of adoption fees. By signing this document, you affirm you are of legal age to enter into legal contract in the State of Maryland, and that neither you nor anyone in your household has been convicted of cruelty or neglect on human or animal. Adopter: _____________________________________________________________ Date: ______________________________Co-Adopter: ___________________________________________________________ Date: ______________________________Heart of the Earth Witness: _______________________________________________ Date: ______________________________ ................
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