Lost
Angels Adoption Application
NOTE: Please be aware that adoption donations are, without
exception, NON-REFUNDABLE.
We need to
know as much about you as possible before we consider allowing you to adopt one
of our rescues. The information you provide on our application/contract will
help us determine the best possible match for you, as well as for the dog.
Please answer all questions honestly, as there are no right or wrong answers.
Applications that are not completely filled out will be discarded without
notice. If a question does not apply to you, fill in the blank with
"N/A".
Lost Angels
relies on your donations to care for all the homeless dogs in our care.
Adoption donations range from $125 to $400. This donation helps defray the
costs of veterinary care given to your dog prior to adoption. This care
includes, but may not be limited to, all vaccinations, heartworm testing and
prevention medication, flea prevention, fecal testing and worming if necessary and
surgical procedure for spay/neuter. Your adoption donation also helps to feed,
house and provide veterinary care for the dogs still waiting to be adopted, and
is NON-REFUNDABLE. You are not buying a dog, you're making a
donation. Out-of-state adoptions are acceptable but we do not ship our
companion dogs and adopting families must come to Lost Angels to complete the
adoption. Sorry, no exceptions.
Animal
Name:
______________________________________
Gender: Male Female
Description:
________________________________________________________________
Applicant’s
Full Name:
________________________________________________________
Address:
___________________________________________________________________
City,
State, Zip:
____________________________________
Email
Address:
_____________________________________
Daytime Phone:
_______________________ Alternate
Phone: _______________________
Please provide reason for wanting a new pet: ___________________________________________________________________________
Is the pet for: You Your Family
Someone else
If someone else, who:
_______________________________
How many
hours per day will the animal be left alone?
Less than 3; 3-5; 5-8; More than 8
Will the
pet be kept Inside Outside
Where will
your new pet sleep?
_________________________________________________
Have you
previously owned other animals? Yes No
If yes,
list pet(s) name(s) and tell what happened to each of them.
______________________________________________________________________________________________________________________________________________________
Do you
currently have other pets? Yes No
If yes, how many and what is/are their name(s)?
__________________________________________________________________
Are your
other pets spayed or neutered? Yes No
If no, give reasons: __________________________________________________________
Are your other pets current on shots, heartworm
preventative, vet care? Yes No
If not, specify which pets and why not: ______________________________________________________________________________________________________________________________________________________
Have you
ever completed an application for a LAAR animal before? Yes No
Do you have
children? Yes No
Ages:
______________________________________
Do you work
outside the home? Yes No
Employer
Name:
_________________________________________ Phone:
____________
Address:
___________________________________________________________________
Drivers
License #:
___________________________________________________________
If you
rent, provide name and phone number of apartment complex/landlord:
Name:
________________________________________________ Phone:
_____________
Address:
___________________________________________________________________
Do you have
a fenced in yard? Yes No
What type
of fencing: Wood Chain Link
Brick Wall
Other:
________________
How high is fencing:
4 ft 5 ft 6 ft Other:
_________
What is the
name of your current veterinarian?
_____________________________________
Clinic
Name:
___________________________________________ Phone:
_____________
Address:
___________________________________________________________________
Lost
Angels Adoption Contract
This
agreement is made between Lost Angels Animal Rescue, Inc. (further known as
LAAR) and the adopter. By signing below, you are acknowledging receipt from
LAAR, the dog described within the application. Adopting party must be 21 years
of age or older and agree to be bound to and comply with the following terms
and conditions (if completing online, please check each item; if completing in
paper format, please initial each item):
___I
understand that a home visit by a LAAR representative is required as a
condition of this adoption approval.
___ I
understand that written approval AND proof of deposit payment will be required
from a landlord as a condition of this adoption.
___ I will
have this dog seen by a licensed veterinarian of my choice, at my expense,
within 72 hours from the date of this contract. Thereafter, I will have this
dog examined at least one a year by a veterinarian and immunized as recommended
by that veterinarian, at my expense.
___I will
seek appropriate veterinary care and/or treatment for this dog if he/she should
become sick or injured.
___I will
provide a loving, safe, happy, clean, and gentle home for my new pet at all
times.
___I will provide proper and sufficient food and
water for my new pet at all times. I understand that premium pet foods are
better for my dog and that certain grocery store brands have been linked to
diseases in animals. I will make every effort to provide the best food
available at least twice a day (i.e., Nutro, Iams, Eukanuba, etc).
___I
understand that I am adopting an indoor dog and will make him/her an indoor
member of my family. This animal shall never be maintained outside as a yard
dog, and shall never be staked out or chained.
___I will
keep my pet parasite and flea-free and will use a veterinarian-recommended
product such as Advantage, Frontline, or Revolution monthly. Generic store
brands (i.e., Hartz) can be harmful or deadly.
___I will
keep my pet on a heartworm preventative recommended by my veterinarian.
___I will
not permit this animal to run at large or to become a public nuisance, and will
always keep means of identification on him/her at all times. I will immediately
retrieve this animal from any public or private facility when notified. In the
event this animal becomes lost, I will make every reasonable effort to relocate
and claim this animal including notifying LAAR.
___I have
been advised to clean my pet's ears and teeth regularly, and to trim his/her nails.
I will discuss this with my veterinarian if I have any difficulties.
___This
animal will not be transported in an open pickup truck or car.
___No one
in my home, including myself, had or now has a pet-related allergy that has not
been disclosed to LAAR.
___If I
can no longer keep or care for my pet at any time during his/her life, I agree
to contact LAAR. LAAR will only be able to take the dog back based on foster discretion and availability. If I return this animal to LAAR for any reason, I
will at no time assert any claim, charge or demand of any kind or nature
against LAAR for any charges that may have been incurred by me, including
veterinarian fees, in connection with this animal.
___I will
not use, sell, nor donate my pet for research purposes and understand that ownership
of this pet may not be transferred to any other person, firm, corporation or
organization for any reason whatsoever.
___I
understand that an animal can be unpredictable and that LAAR cannot anticipate
or insure against unexpected conduct of an animal adopted from LAAR. I
acknowledge that LAAR has not made through its volunteers, any warranties
regarding the future condition, temperament or conduct of this animal. I hereby
accept this animal as is, assume all risks and responsibilities associated with
ownership of this animal, including bites, and I hereby fully and completely
release, indemnify, and hold harmless, LAAR, its directors, volunteers, and
agents from any claim, cause of action or liability of any sort or nature,
whether, known or unknown, directly arising out of or in connection with the
adoption, care or ownership, maintenance, retention, temperament, conduct or
condition of this animal.
___I agree
to communicate with LAAR during the new pet adjustment period to ensure that a mutually
satisfactory relationship is established in the new home.
___I agree
to allow LAAR to visit my new pet in my home by appointment.
___I agree
to make a donation for each puppy/dog adopted. (Donations range from $125 to
$400 depending on breed/size.) I understand that a fee of $25.00 and/or
immediate return of this animal, as deemed by a LAAR Director, will be incurred
upon the receipt of an insufficient check.
___I
understand that my adoption donation is non-refundable.
___This
contract may be specifically enforceable by LAAR through judicial proceedings,
including the right of LAAR to recover the animal due to any breach of any
terms of this contract. I hereby agree that in the event I breach this contract
and LAAR files suit to enforce this contract or to defend any claims under this
contract, I will pay any court costs and attorney's fees incurred by LAAR in
connection herewith.
___By
checking this box, I understand that this is considered a signed contract.
Signature
of Adopter:
_________________________________________________________
Date: __________________________________
Print
Name:
________________________________________________________________
Foster Parent signature here:
_______________________________________________________________
Lost Angels Animal Rescue, Inc.
(813)514-0595
www.lostangelsanimalrescue.org