Adoption Application Form - SEQ K9 Rescue Inc

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About Us
Services
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Contact

Thank you for choosing to adopt with SEQ K9 Rescue Inc.

Please complete this form and our adoption team will be in contact with you within 48 hours.

You can contact us directly at [email protected] if you have any queries.

Dogs Name you are Applying for *

Gender *MaleFemale

Where did you see this dog advertised?

Other

First Applicants Details

First Name *

Last Name *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Phone *

Date of Birth *

Day *

Month *

Year *

First Applicants Email Address *

Second Applicants Details

Second Applicant First Name

Second Applicant Last Name

Second Applicant Phone

Identification *Drivers Licence18+ CardMedicare CardBirth CertificatePassportOtherPlease tick the box of the two forms of ID you are providing. One form of One form of ID must have your photo. Please send a copy of your ID to [email protected] with your name and animal reference or name. If selecting other please remove any other selections.

Other Identification

Office use only: ID Sighted 1

Do you Currently Own a Dog

What Breed is your Dog?

What is your Dogs Age?

What is your Dogs Sex?

Have you ever surrendered an animal to a rescue group or pound? *

What is your Reason?

What Previous Dog Experience do you Have? *

Do you Have Other Animals *

What are Those Animals?

Do you have any children regularly visiting or living in your home? *

What are their Ages?0 - 5 Years5 -10 Years10 - 15 YearsOver 15 years oldNo Children

Are your Fences Secure? *

How High are your Fences? *

What are your Fences Made of? *

What Type of Property do you Currently Live In? *

Other Type of Residence

Do you Rent or Own your Home? *

Do you Have Permission from your Real Estate to have a Dog?

Will your Dog Sleep Inside or Outside? *

Where Outside Will the Dog Sleep?

Will the Dog be Mostly Inside or Outside During the Day? *

Other Conditions of Doggie Daytime

On a typical day, how long will the dog be left alone? For example, if you work full time you will be gone for more than 8 hours a day. *Less than 4 Hours4 - 8 Hours8 - 12 HoursMore than 12 Hours

If the dog develops behavioural issues are you willing to seek professional training? *

Are you aware a SEQ K9 Rescue Inc. representative may request a property check? *

Would you like to add any further information about your family or home?

Terms and conditions of the two-week trial

1. The 2 weeks’ trial begins on the day you collect your dog. Your dog can be returned to SEQ K9 Rescue Inc. at any time if your circumstances change.
2. I agree if I adopt a pup I will not take my pup out of my yard until he/she is fully covered by the vaccination.
3. I agree that I will contact SEQ K9 Rescue Inc. if I become aware of any behavior issues.
4. Pre-Adoption deposits of $50 are non-refundable
5. If we decide to return the dog within the 2 week trial period, I will be charged an Administration fee of $50 (Refunds will be direct deposited into your bank account within 5 working days) This fee will be taken out of the refunded adoption fee.
6. Should the dog require any medical attention; I agree to contact SEQ K9 Animal Rescue Inc. immediately. Any veterinary costs incurred by me without the agreement of SEQ K9 Rescue Inc. will not be refunded. I may be asked to contribute to the cost for any issues deemed as being caused by me or as a circumstance of my care of the animal.
7. If the animal is impounded during the two-week trial period by any council or private facility including a veterinary surgery, I will be responsible for paying impound or any other fees to have the animal released to SEQ K9 Rescue Inc.
8. I agree that any damage done to property by the dog will not be refunded by SEQ K9 Rescue Inc.
9. If at any time, SEQ K9 Rescue Inc. become aware that the dog is being mistreated or is being harmed SEQ K9 Rescue Inc. may seize the dog without notice. We may have the dog assessed by a veterinarian and/or a behavioral specialist. It is up to the veterinary advice we receive whether the dog is returned to you. If the dog is deemed to still be at risk, the dog will be retained by SEQ K9 Rescue Inc. Your adoption fee will be forfeited and you will be reported to the appropriate authorities.
10. Should the dog be responsible for any damage or injury to a human, another animal or livestock I agree that I release SEQ K9 Rescue Inc. of any responsibility for any legal action.

By ticking the box you agree to the terms and conditions of the two-week trial *Yes, I AgreeNo, I do not Agree

By signing this agreement and completion of the two-week trial you agree to these terms and conditions

1. Maintain and house the dog under the conditions of the applicable State Act governing the care of companion animals.
2. Meet all the required Council by-laws in your area, including obtaining appropriate permits.
3. Understand that it is your responsibility for any costs or charges that are incurred should your animal be impounded by the Council.
4. To provide all veterinary treatments, including vaccinations and immediate treatment of any illness or injury at your cost.
5. That all pre-known medical conditions have been disclosed and accepted by you prior to the adoption process being finalized with you and you release SEQ K9 Rescue Inc. from any liability from conditions found after the adoption is finalized.
6. To keep the animal’s microchip records up to date always.
7. To seek advice from a professional registered behavioral trainer should the dog develop any serious behavior issues?
8. That should you find that you can no longer care for the animal, that you contact SEQ K9 Rescue Inc. immediately. We will do our best to either take the dog back into care or help with re-homing. There will be no refund of the adoption fee in this circumstance.
9. Understand that SEQ K9 Rescue Inc. cannot be held responsible for the animal should the animal develop an illness or an unsatisfactory temperament once adopted.
10. If the dog I have adopted is subsequently deemed a dangerous dog by the appropriate authority, SEQ K9 Rescue Inc. will not be held liable for actions taken against the adopting party.
11. I understand that the animal has been de sexed, micro chipped, vaccinated, wormed.

Desexing, Microchipping, and Vaccinations *I understand all dogs adopted from SEQ K9 Rescue Inc will be desexed, microchipped, and vaccinated before an adoption will be considered final.

Damage to yourself and property *I understand that SEQ K9 Rescue are in no way responsible for any injury, death, or damage to persons or property from this date onwards and/or as soon as I take physical possession of the animal mentioned above.

By ticking the box you agree to the terms and conditions set by SEQ K9 Rescue Inc. *Yes, I AgreeNo, I do not Agree

Declaration

I acknowledge that I have read and accepted this adoption agreement. I understand that all the information I have provided to SEQ K9 Rescue Inc. is true and correct to the best of my knowledge. I understand that failure to comply with the requirements of this agreement can result in seizure of the dog.

Sign Your Name Here

Date

Office Use OnlyRepresentatives Signature Above

Please do not fill in this field.