Street Dog Hero

Adoption Application

Adoption Application

Name *
Name
Address *
Address
Phone *
Phone
Birth Date *
Birth Date
Reference 1 *
Reference 1
Personal References Please list someone other than a family member
Phone *
Phone
Reference 2 *
Reference 2
Personal References Please list someone other than a family member
Phone *
Phone
If you rent a copy of your lease or landlord approval will be required
TYPE OF ANIMAL, BREED, AGE, M/F, SPAYED/NEUTERED, INDOORS/OUTDOORS, OWNED FOR HOW LONG?
If yes, please explain the situation.
Please Acknowledge Agreement and Understanding of the above responsibilities
All of the above information I have given is true and complete. If I adopt a dog from Street Dog Hero, the pet will reside in my home as a pet. I will provide him/her with adequate water, a quality dog food, shelter, training, affection and medical care. I understand that Street Dog Hero is a referral service and is not responsible for the accuracy of information received about the habits, temperament, or physical condition of the dogs available for adoption. I understand it is my responsibility to evaluate a dog for myself before agreeing to adopt him/her. I am in full agreement of the terms of the adoption. Street Dog Hero shall not be liable for, and is hereby relieved from, all liability for any damage, expenses, causes of action, fines, suits, demands, judgments, or claims of any nature whatsoever arising from or by any reason of any damage to property or injury to any persons caused in whole or in part during the visitation of the dog up for adoption AND a dog placed in your home. I hereby accept and assume such liability and agree to protect, indemnify and hold Street Dog Hero and it’s representatives harmless from and against all of the aforesaid. Completing and returning this document constitutes your permission for us to check references. *
All of the above information I have given is true and complete. If I adopt a dog from Street Dog Hero, the pet will reside in my home as a pet. I will provide him/her with adequate water, a quality dog food, shelter, training, affection and medical care. I understand that Street Dog Hero is a referral service and is not responsible for the accuracy of information received about the habits, temperament, or physical condition of the dogs available for adoption. I understand it is my responsibility to evaluate a dog for myself before agreeing to adopt him/her. I am in full agreement of the terms of the adoption. Street Dog Hero shall not be liable for, and is hereby relieved from, all liability for any damage, expenses, causes of action, fines, suits, demands, judgments, or claims of any nature whatsoever arising from or by any reason of any damage to property or injury to any persons caused in whole or in part during the visitation of the dog up for adoption AND a dog placed in your home. I hereby accept and assume such liability and agree to protect, indemnify and hold Street Dog Hero and it’s representatives harmless from and against all of the aforesaid. Completing and returning this document constitutes your permission for us to check references.
Date *
Date