Adopter's
Name:________________________________
Address:_______________________________________
City:__________________________________________
State:_________________________________________
Zip:___________________________________________
Phone:_________________________________________
Email:_________________________________________
ID:____________________________________________
It is accepted that on this ________ day of ________________ the above named person(s) adopted from Unchained Love, Inc. ____________________________, canine described as follows:
Breed:_________________________ Name:__________________________ Sex:___________________________ Color:_________________________ Age:___________________________
For the fee of $_______________ - Under the following terms and conditions:
I/We hereby agree to care for this dog humanely (including providing adequate food, water, shelter, love and attention). Said dog shall be maintained in an adequate and safe enclosed area or on a leash at all times. Dog is to be kept inside the house when home alone and never be left unattended outside. Dog shall not be allowed to roam at will.
I/We agree to have dog on heartworm prevention, vaccinated annually with necessary inoculations (DHLP-P), and vaccinated against Rabies, as local ordinances require. I/We agree to provide essential veterinary care as needed.
If said dog becomes lost or stolen, I/We agree to notify Unchained Love Inc. immediately. I/We also agree not to sell, trade, giveaway or dispose of this dog. If, at any time, I/We are unable or unwilling to care for this dog, I/We agree to contact and return said dog to Unchained Love representative.
I/We agree that said dog will not be used for any illegal purposes and will NEVER be fought in any way. If this clause is broken, I/We understand that the dog will be immediately confiscated by Unchained Love representative and all law enforcement agencies will be notified, as applicable. I/We certify that we do not live in an area with a breed specific ban.
I/We agree to notify Unchained Love representative within 10 days of any change of address or phone number. It is also understood that Unchained Love representative may examine and make inquiries about said dog at any time. If not satisfied with the condition of the dog or the conditions in which it is kept, said dog can or may be removed immediately and placed in a different home. Any veterinary services needed due to negligence or lack of care will be the adopters responsibility and payable to Unchained Love representative.
I/We understand that Unchained Love representative makes no guarantees or warranties regarding the health and/or temperament of this dog. I/We promise and agree to be solely responsible for this animal, and to indemnify and hold harmless Unchained Love, Inc. and/or Unchained Love representatives from any and all claims of liability for the conduct of this animal on or after the date of this adoption. This Release of Liability and Indemnification shall apply to all known, unknown and unanticipated damages resulting from my/our adoption, ownership or control of such animal.
I/WE HEREBY ACKNOWLEDGE THAT I/WE HAVE READ AND UNDERSTAND THE ABOVE TERMS AND CONDITIONS AND WILL KEEP THE DOG DESCRIBED HEREIN AS A FAMILY MEMBER. I/WE UNDERSTAND THAT THIS IS A BINDING CONTRACT ENFORCEABLE BY CIVIL LAW.
Print Name:____________________________
Signature:_____________________________ Date:________________
Unchained Love, Inc. Representative:
Print Name:____________________________
Signature:_____________________________ Date:________________