First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
Email*
Home Phone*
Cell Phone*
Alt Email
Which pet are you interested in adopting? Choose an animal: A - Other - Pet not listed Alistair Angelique Blueberry (AKA Jenny) Celly Christy Cindy Lou Delta Diamond Divinity Finnegan Franklin Lady Larry Lo Mein Moonie Nash Paisley Pigeon Porky Sasha Tater Will Willow 2 Woody
What is the name of the pet you are interested in adopting? (Only answer if it is not listed above)
Why do you want to adopt this particular animal*
Where will this pet be kept while no one is at home?*
Where will this pet be kept at night?*
Do you own or rent your home*
** IF YOU ANSWERED OTHER, RENT, OR FRIEND/RELATIVE ABOVE -- THEN THIS BOX APPLIES TO YOU** If you rent, live with a relative/friend, or answered other above - please enter your Landlord's name and phone number or explain other! Enter N/A only if you own your own home and this does question does not apply to you.*
Do you have a fenced yard?* Choose one: Yes No
Describe your fence, if applicable or how you plan to walk/supervise your dog if you do not have a fenced yard. *
How many people live in your home?* Choose one: 1 2 3 4 5 or more
How many pets do your currently have?* Choose one: None 1 2 3 4 5 or more
Please list the Breed, Age, and size of current pets. (enter N/A if this does not apply to you)*
Are all pets in your home spayed/neutered? * Choose one: Yes No N/A (I do not have any pets)
If you answered no to above question, please give pet name and reason for not spaying/neutering pet. Enter N/A if your answered yes to the question above.*
Have you had any other pets in the past 3 years? Where are these pets now?*
Please list your current veterinarian's name and phone number. (Enter N/A if you do not have a current vet.)*
Please list the name(s) in which your vet records are listed at your vets office (Please alert your vets office they may receive a call from Krewe de Rescue for a reference and to please share the needed information with us.) (Enter N/A if you do not have a current vet)*
Name under which previous vet records were listed. Enter N/A if this does not apply.*
DUE TO PRIVACY LAWS, PLEASE CALL YOUR VET AND LET THEM KNOW KREWE MAY CONTACT THEM FOR YOUR INFORMATION. BY TAKING THIS STEP AND GIVING PERMISSION TO SPEAK WITH US ON YOUR BEHALF ABOUT SERVICES PREFORMED FOR YOUR PETS, THIS WILL HOPEFULLY KEEP DELAYS IN PROCESSING YOUR APPLICATION TO A MINIMUM.
Please list two (2) personal references. Please include name and phone numbers.*
Please list any additional comments you would like Krewe de Rescue to know or use in determining your adoption status
This agreement is entered into between Mobile County Humane Society, Inc dba/Krewe de Rescue ("KDR") and the applicant ("Adopter") for the adoption of any rescue dog(s) ("the dog(s)") from KDR. Terms and Conditions: Please read and check each box below indication your agreement to abide by the terms and conditions of this contract.
Adopter agrees the dog is being adopted to be a family companion and agrees to provide the dog with a safe home, adequate food, water, shelter, proper veterinary care, exercise, love, and attention. Adopter agrees not to violate any laws or ordinances with the dog. The dog shall not be used as an attack or protection trained dog and shall not be used as a commercial guard animal. Furthermore, adopter agrees to teach all children in the household what is and is not appropriate handling of a dog. This is for the safety and happiness of both the dog and child(ren). * Choose one: I Agree
Adopter agrees to keep a collar on the dog at all times with ID tag, current rabies tag, and city/town dog license, if required. Choke collars are only allowed during training and walks. If at any time the dog is lost, stolen, hurt or killed, the Adopter must notify KDR by email or phone immediately. * Choose one: I Agree
Adopter agrees to have a clean, safe, and secure fenced area for the dog. If a fenced enclosure is not available, Adopter agrees to leash walk dog. If Adopter uses invisible fencing, the dog is to be sufficiently trained before releasing it inside the system. Under no circumstances is the dog to be kept on a runner or tie out. * Choose one: I Agree
Adopter agrees that the dog will be an “inside” dog and kept inside the home when adopters are out and dog is unsupervised. When the Adopter is away for a prolonged period of time or on vacation, Adopter shall pre-arrange appropriate care for the dog. * Choose one: I Agree
The dog shall not ride loose in the bed of pickup trucks or convertibles and shall not be locked alone in a car at any time for any reasons regardless of the temperature. * Choose one: I Agree
Adopter agrees to have the dog examined by a licensed veterinarian at least once each year and shall ensure the dog is current on all vaccinations and treatments necessary to ensure good health. If euthanasia becomes necessary, Adopter shall have it performed by a licensed veterinarian. * * Choose one: I Agree
KDR is unable to provide guarantees or statements regarding the dog's age, breed, health, or temperament. While KDR makes every effort to provide accurate history and assessment on the dog, KDR is not able to guarantee a dog’s age, breed, medical status, behavior or disposition. Adopter agrees and shall release KDR and its members or representatives of any and all possible claims arising from injury or damage caused by the dog to any person or property. Adopter accepts this dog as is in its current health condition, personality, and disposition, either observable or un-observable, and assumes all risk for the dog upon signing of this contract and once the dog is transferred to your custody. Upon signing this contract and placement of the dog into your custody the responsibility of said dog is exchanged from KDR to Adopter and all legal liability for the dog is released from KDR and thus becomes the Adopter’s. * Choose one: I Agree
This agreement shall inure to the benefit of and be binding upon Adopter and KDR and their successors or beneficiaries. Both parties have fully read and understood each clause of the agreement, which sets forth all promises, conditions, and understandings, oral, or written. * Choose one: I Agree
If for whatever reason the Adopter is unable to keep the dog for its entire life, the Adopter must return the dog to KDR. Adopter must agree to not give away, sell or dispose of the dog without the express written consent of KDR (except for euthanasia for medical purposes only with a written consent by a licensed veterinarian in which case KDR must be notified and provided with a “Cause of Death” certificate).* Choose one: I Agree
Should the adopter decide to return the dog, the adopter agrees to pay the fee needed to transport back to Mobile, Alabama* Choose one: I Agree
In the event this contract and all its covenants and conditions is breached by Adopter, KDR shall rescind this contract and demand the dog be returned to the custody of KDR. If Adopter fails to comply, KDR has the right and shall seek a Court Order for return of the dog, as well as seek liquidated damages from the Adopter in the amount of not less than $750 plus any court costs or attorney’s fees. Payment of damages shall not excuse Adopter from returning the dog to KDR. * Choose one: I Agree
The Adopter understands that the first one to two weeks after adoption are considered a “period of adjustment” for both the dog and the Adopter/adopter’s family and understands the dog may display behaviors consistent with being scared such as shyness, eliminating when excited or afraid, being protective of food or displaying poor appetite and/or unsure of other dogs in the family. * Choose one: I Agree
By typing/writing your name in the space provided below, Adopter agrees to be bound by the terms and conditions of this contract.*