WPR Dog & Puppy Adoption Application / Contract

**To adopt a Waverly Pet Rescue dog you must be over the age of 21 and have DOG experience as an adult and an excellent vet reference for past and current pets. It must be your vet reference, not your parents. Please do not apply if you do not have a vet reference. We do not adopt to first time pet owners. **

Your application will not be approved:
-if all animals in your household are not spayed/neutered AND up-to-date on shots. Wait to apply until they all are.
-if you have Drugs, Assault, Domestic Abuse or similar charges on your record. We do background checks in all states.

PLEASE DO NOT APPLY IF:

-You did not take your past pets to the vet at least once a year. To be approved to adopt from Waverly Pet Rescue, you must have proof that you did take your pets to the vet at least once a year, did vaccination updates if recommended by your vet, did blood-work if recommended by your vet. You can prove with hard copies of past records if your vet no longer has the information in their system.

Fill in all answers, do not leave any spots blank or it may not work. You will get an automated email after submitting this application letting you know we received it. If you do not get that email, please let us know or please try the application again. Thanks!

ADOPTION APPLICATION & CONTRACT

Waverly Pet Rescue

PO Box 291

Waverly, IA 50677

Our purpose is to place an animal in a responsible home where it will receive veterinary care when needed, and where it will be controlled so as to not become a free roaming animal, or add to the surplus of animals already in the community. All homes must be indoors.

In order to be considered for an adoption today you must be 21 years of age, have knowledge and consent of all adults living in your household, have a valid Id with current address, your landlord’s name and phone number.

Understand that your WAVERLY PET RESCUE adoption application must be approved and we reserve the right to refuse any adoption.

What is the name of the animal you are applying to adopt? *

First, Middle, Last Name of Adults in household: WE DO BACKGROUND CHECKS, SO IF YOU HAVE DRUGS, ASSAULT, DOMESTIC ABUSE, ETC, PLEASE DO NOT APPLY.
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Birthdates of Adults in household: WE DO BACKGROUND CHECKS, SO IF YOU HAVE DRUGS, ASSAULT, DOMESTIC ABUSE, ETC, PLEASE DO NOT APPLY.
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Full Address (Street address)
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City, state, zip code
*

How long have you lived at this address?
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Do you rent or own your place of residence?
(We do check the county assessor's web-site to verify who owns the property. So if you rent, Do Not Put that you own. If you rent, we must get your landlord's name and number.)
*

Landlord name and phone # if you rent: (We do call your landlord to verify you can have a pet. Please check with them now to see if you have a pet deposit or paperwork to fill out. It is best if that is all taken care of first before we call) *

Please list previous address before you current one. When did you live there and for how long? Did you rent or own? If you rented, please list landlord name and number. *

Home Phone #: *

Cell Phone #: *

Employer for all adults and how long: *

Ages of children in household: *

Have you ever adopted an animal from a shelter or rescue before? *

If yes, what shelter or rescue did you adopt from and when? *

Have you ever been refused adoption of a pet from a shelter or rescue, if so please explain. *

Please describe in your own words why you would like to adopt this pet? *

***IF YOUR PET IS NOT FIXED OR UP TO DATE ON SHOTS, PLEASE DO NOT APPLY UNTIL THEY ARE.***
***YOUR APPLICATION WILL NOT BE APPROVED IF YOUR PETS ARE NOT FIXED OR UP TO DATE ON SHOTS. DO NOT APPLY BECAUSE WE DO CALL FOR A VET REFERENCE TO VERIFY THIS INFO**

Please do not apply if your current pets are not altered - males neutered or females spayed - regardless of the type of animal you are applying to adopt.

What kind of pets do you own now or have owned in the past 5 years:
Pets Name, Breed, Kept Where? Age Spayed/Neutered? Sex Still Own, if no why? *

If you have pets now or in the past, who is (was) your veterinarian?
Name and phone #: *

Would you allow us to speak with your vet to get a reference from them? If no, please explain why not.
*

If you adopt a new pet, who will the vet be? Name and phone #: *

What shots has your pet had within the last year? *

When was your current pet’s last visit to a vet? *

Are your current pets' vaccinations current? If no, why not?
*

Are your current or past pets' all spayed / neutered? If no, why not? *

Are you willing to take your dog / puppy to the vet at least once a year for shot updates and a check-up? *

Do any family members have allergies to animals? If Yes, please explain: *

If you move in the future what will you do with your pet? *

Do you have a fenced yard? If not, do you plan to fence? *

Do you understand that state laws require vaccinating your pet? *

Please provide a description of what you consider to be routine vet care. *

Do you plan on using a chain or rope to tether the dog? *

Do you plan to take your dog to training classes? *

Where will your pet be kept during the day? *

Where will your pet be kept at night? *

What type of identification will be placed on your pet? *

What arrangements will you make for your pet when you are out of town? *

Will you let your pet roam outside unattended? *

Is this pet a gift to someone? Please explain if yes. *

Animals are as individual as humans are. Are you willing to spend the time, effort, & patience required to help this pet adjust to its new home, family, & lifestyle? (It can take days or even weeks for a new pet to adjust) *

What will you do to help your new dog or puppy adjust to its new home? *

What will you do to help your new dog or puppy adjust to other animals in the household?
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What will you do to help your new dog or puppy adjust to children in the household?
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What have you taught your children about animals? *

Do you promise to return this pet to WPR if you cannot keep for the rest of their life? To never give this pet away or take to a shelter? *

Is this pet a gift to someone? Please explain if yes. *

Under what circumstances would you not keep a pet? *

Have you had pets in the past that you have sold, taken to a shelter, or given away? If yes, then please explain: *

Are all members of your household aware of and in agreeement with this adoption? If not, please list who is not in favor of the adoption and the nature of their concerns or objection. *

If there were circumstances beyond your control that forced you to give up this pet, would you agree to contact us BEFORE placing the pet in another home? *

If your existing pet or a new pet became destructive, what would you do? *

What is your plan if the new pet if not completely housetrained? *

If your pets were to survive you, what would happen to them? Who would take responsibilty for them? *

What type of pet are you looking for? *

Would you object to a home inspection? *

In adopting this pet, the owner agrees to:

1. Accept and keep the dog / cat as a companion.

2. Provide humane care – giving pet proper food, water, shelter, exercise, and attention.

3. See that a veterinarian gives this pet regular preventative care and immediate medical attention when it becomes ill or injured.

4. Not permit the animal to be used for vivisection or experimentation.

5. Comply with all state, county, and municipal laws pertaining to animals.

6. Indemnifies and holds harmless Waverly Pet Rescue for any damages which the pet may do to any person or property.

7. Return the animal to Waverly Pet Rescue if it can no longer receive adequate care (food, shelter, affection and attention).

8. Understand that adopting an animal is a 12-20 year commitment.

9. If not already done, spay or neuter the pet within 30 days.
10. If for any reason it does not work out with the pet adopted, you MUST return the animal ASAP. Even if it is 5 or 10 years later, we need to have the animal back if you cannot keep or for any reason.

No refunds given for an adoption return unless a medical problem develops within seven (7) days. The animal may then be returned with a veterinarian’s statement regarding the problem, and the adopter may request their adoption fees be refunded.
Please make sure you are 100% sure this pet is the one for you before you adopt it. It is very hard on an animal when they get returned.

Waverly Pet Rescue is not responsible for any expenses incurred in treating the animal after adoption.

WAVERLY PET RESCUE reserves the right to REFUSE adoption of an animal to a home that does not meet the above standards. This includes the right to follow up animal adoptions and remove the animal if:

1. The animal is not receiving adequate care.

2. The animal is being abused.

3. The dog is penned outside day and night or housed in a garage or out building all the time with no human interactions.

4. The cat is allowed to roam outside unsupervised by its owner.

5. If proof of spay / neuter is not received.

ALL SHOTS, MEDICINE, VERTERINARY EXPENSE, BOARDING, AND OTHER LIABILITY OBTAINED AFTER ADOPTION ARE THE SOLE RESPONSIBILITY OF THE OWNER.

If the following statement is checked, it applies to the animal I am adopting:
__________I have been fully informed that the animal has previously bitten someone and assume any and all risk for the animal and indemnify WAVERLY PET RESCUE and hold it harmless for any further actions of this animal.

By signing below I certify that I have read all the above information and have provided all true information. I recognize that any misrepresentation of facts may result in my losing the privilege of adopting or keeping an adopted pet. I understand that Waverly Pet Rescue has the right to deny my request to adopt an animal, and I authorize investigation of all statements in this application. I understand that this application is the property of Waverly Pet Rescue.

***IF YOUR PET IS NOT FIXED OR UP TO DATE ON SHOTS, PLEASE DO NOT APPLY UNTIL THEY ARE.*** ***YOUR APPLICATION WILL NOT BE APPROVED IF YOUR PETS ARE NOT FIXED OR UP TO DATE ON SHOTS. DO NOT APPLY BECAUSE WE DO CALL FOR A VET REFERENCE TO VERIFY THIS INFO**

Please do not apply if your current pets are not altered - males neutered or females spayed - regardless of the type of animal you are applying to adopt.

Adopting Party Signature and Date: *

Your email address: *

How did you hear about the Waverly Pet Rescue? ( newspaper, radio, TV, friend, search on internet, petfinder, Facebook, adopted from us before, etc.) *