HOGPC Rescue & Placement Policy - Attachment D Sample Transfer Agreement

Adopter's Name:                                                                                   

Phone:                                                                                                 

Address:                                                                                              

Former Owner's Name:                                                                         

Phone:                                                                                                 

Address:                                                                                              

Dog's Name:                                                                  Breed:                                      

Age:                             Sex:                              Color:                                      

Date of last Vet Check-up:                                   DHLP                             Rabies              

                                                                        Heartworm check                      

Next vaccinations & Heartworm check will be needed:                  

To the best of my, (former owner), knowledge, this dog has no defects that would make it unsuitable as a family pet. I certify that this dog has never bitten or injured anyone.

I/We, (adopter(s)), understand and agree to the following terms of this contract and understand that non-compliance with the terms of this agreement gives the adopting agent/former owner the right to reclaim this dog without refund of the adoption fee.

Ø       An adoption fee of $             will be collected at the time of adoption.

Ø       This dog shall be kept and cared for as a family pet in a humane manner and given appropriate shelter and medical care for the duration of its life.

Ø       I/We agree to abide by all state and local animal control and leash laws.  I/We understand it is my/our responsibility to become familiar with these laws.

Ø       I/We understand that                        (former owner/agent)                 makes no guarantees or warranties regarding the health or temperament of this dog.  I/We agree to adopt this dog and to be solely responsible for this animal and any damages that may result from its actions.                   (former owner/agent)                 shall not be held liable for the behavior of this dog or any damages it may cause.  I/We understand that this is a binding contract enforceable by civil law.

Date of adoption:                                              

Adopter’s signature

Former Owner's Signature