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Blue Ridge Doberman Rescue
Post Office Box 232254
Centreville VA 20120-8254
(703) 753-6409
ADOPTION AGREEMENT
Adopter Information:
Name: _______________________________________________________________________________________
Home Address: ________________________________________________________________________________
Phone: __________________________________ (home) _________________________________________(work)
Driver’s License State and #: ___________________________
e-mail: ____________________________________
Description of Doberman Pinscher adopted:
Name: ____________________________________________
BRDR ID# ________________________________
Sex: M/F Color: ____________ Age: _______ Ears: Nat/Crop
Tail: Nat/Dock Spay/Neuter date: ___________
In consideration of my receiving the Doberman Pinscher described above, I do hereby agree to the following terms and conditions:
1. To allow my dog to live in my home as a part of my family, and care for the dog in a humane manner (including but not limited to adequate food, water, shelter, veterinary care and love).
2. To ensure that the dog is maintained on heartworm preventative and keep all immunizations and vaccinations current according to a veterinarian’s schedule.
3. To ensure that the dog wears a collar and identification tags at all times, and that the dog’s primary collar shall not be a choke chain.
4. To license the dog in accordance with the laws and ordinances and to abide by the leash laws and ordinances of the municipality, county and state in which Adopter lives.
5. If this dog has natural ears and/or tail, not to subject it to the unnecessary pain and stress of cropping its ears or docking its tail for cosmetic purposes.
6. Not to sell, trade or otherwise dispose of the dog in any way, but to notify Blue Ridge Doberman Rescue if I wish to relinquish custody. If the dog is returned to Blue Ridge Doberman Rescue within two weeks of adoption, 50% of the adoption fee will be returned to the adopter. The remaining 50% will be retained by Blue Ridge Doberman Rescue for re-homing expenses.
7. No AKC registration certificate, if applicable, will be transferred to the Adopter.
8. To promptly notify Blue Ridge Doberman Rescue of any change of address and/or telephone number.
9. Not to cause or allow the dog to be used for experimental purposes, as an attack dog, or as a guard dog, nor to let the dog ride in the open bed of a pick-up truck.
10. That Blue Ridge Doberman Rescue reserves the right to examine and make inquiry about the dog at any time. If Adopter fails to maintain the dog in accordance with the terms of this Agreement, Blue Ridge Doberman Rescue may reclaim the dog and Adopter will be responsible for all veterinary, transportation and attorney’s fees incurred as a result of such action.
11. That all information on the Adopter’s application is true and correct.
12. Adopter agrees to release and hold harmless rescuer and Blue Ridge Doberman Rescue, concurrently and severally, from any and all liability for any injury, death or damage, directly or indirectly caused by the dog. Adopter does hereby release rescuer and Blue Ridge Doberman Rescue from any and all liability, claims, suits, demands, or causes of action which may arise out of or be brought against rescuer and/or Blue Ridge Doberman Rescue by virtue of the release of dog to adopter. It is the expressed intention of adopter, rescuer and Blue Ridge Doberman Rescue that the release provided for in this paragraph is designed and intended to protect rescuer and Blue Ridge Doberman Rescue from the consequences of any attack, behavior or other action by the dog, and from the consequences of any act or omission or negligence on the part of rescuer or Blue Ridge Doberman Rescue in obtaining custody of the dog, in providing care for the dog, or in failing to provide timely or adequate warning to any person concerning the dog.
13. Adopter understands that rescuer and Blue Ridge Doberman Rescue make no warranties (expressed or implied) or representations as to the health, fitness, demeanor or well-being of the dog. Adopter accepts the dog “as-is”. Because of this, Adopter understands that rescuer and Blue Ridge Doberman Rescue accept no responsibility if the dog should die after being released to adopter or should bite, scratch, injure, or cause death of any person or animal or cause damage to property after being released into Adopter’s custody.
I, (print name) _____________________________________, hereby acknowledge that I have read and do understand this Agreement.
Adoption Fee of $_250_____ received on ______________________ by Blue Ridge Doberman Rescue.
Signed: _______________________________________________________
Blue Ridge Doberman Rescue
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