Adoption Application and Contract

Will pay via: CashCheck

(This donation is not a fee or sale price, but a request to defer or reimburse rescuer for any and all medical expenses, or any other expenses incurred by the animal or rescuer to enable animal for adoption.)



Please list all individuals living in the home. (Name, Age, Relationship to Applicant)

Do you rent or own?
RentOwn
If renting, please provide your landlord's name and phone number.

Please select all that apply:
Fenced yardDog doorOutdoor kennelTieout cableOverhead cable runDog house
List all current pets. For each pet, indicate species, breed, age, and whether or not the animal has been altered:

List all past pets. For each pet, indicate species, breed, age, and what happened to the animal:

Please describe where this animal will stay during a typical day. How many hours will it be left alone?

Please provide the following veterinarian information.
(Be sure to let them know we will be calling for a reference. Due to new HIPPA laws, veterinarians now must have owner consent to release information for adoption purposes.).

Submitting this application confirms that you recognize the responsibilities (financial and otherwise) associated with providing for an animal for the next 5-17 years. You also acknowledge that a STAR member will contact your veterinarian for a reference, will conduct a home visit, and will collect an adoption fee prior to the adoption's finalization. If you understand and agree to these terms, please continue on to the Adoption Contract below.

All family members have agreed to the adoption of the animal and all family members will abide by the terms of this agreement.
I/we represent that I/we have never been subject to legal action for cruelty to or neglect of animals. I/we further represent that I/we have never owned an animal which has been confiscated by any animal control or humane organization for violations of state or local animal control regulations or animal adoption agreements.
I/We understand that this animal was previously unwanted, a stray or lost and may have been rescued from a dangerous, unhealthy and/or cruel situation. This could have long-lasting effects on the animal. I/We agree that STAR is making no representations or warranties about the condition, personality, or temperament of the animal. The animal was evaluated by a representative of STAR but that not does guarantee its temperament or compatibility with me or any members of my/our household.
I/We understand that STAR makes no explicit or implicit guarantees in reference to the health and/or temperament of the animal. The animal is adopted "as is" and the adopter assumes all responsibility for treatment of any and all existing conditions, or any other conditions of physical or temperament changes that may occur. STAR will provide the animal with spay/neuter, basic vaccines, and heartworm test before rescue if the age and current health of the animal permits. While STAR makes every effort to place only healthy animals, STAR cannot guarantee the health of any animal, and shall not be held responsible for any medical expenses which may be incurred, hereby expressly excluding any implied warranties of merchantability or fitness for any particular purpose, including, without limitation, any warranties regarding health, temperament or whether the animal is housebroken.
I/we agree to notify STAR of a new address within 30 days of residence at new address. I/we also agree to notify STAR of changes to other contact information such as phone numbers and email addresses.
I/we agree to allow the animal to live indoors as a family member. I/we agree that this animal may NOT be kept as an outdoor only animal.
I/we agree not to leave the animal chained, cooped and or otherwise confined for extended periods of time.
I/we agree to provide the animal proper care including providing a diet of wholesome animal food, access to fresh water, appropriate veterinary care and substantial human interaction.
I/we agree to walk the animal for a minimum of 30 minutes per day, weather permitting. I/we understand that exercise is very important for my/our animal and if I/we live in a climate that prohibits regular, daily walks, I/we will obtain a treadmill for our animal.
I/we agree the animal is not to run loose, or otherwise be a nuisance to the neighborhood. I/we agree not to allow the animal to be off-leash unless in a fenced in or contained area.
I/we agree to keep a collar with proper ID tags on the animal at all times and to obtain any necessary municipal licenses in order to prevent this animal from being in violation of city requirements.
I/we agree never to use the animal for fighting or any other “sport” in which one animal is pitted against another, and never to beat or taunt the animal in order to promote aggressive “guard dog” characteristics.
I/we agree not to abandon, give away, sell, transfer, foster out or dispose of the animal in any way, and to notify STAR immediately at any time I/we determine that I/we no longer want, or no longer can keep the animal, so that STAR can take the animal back to arrange another adoption. STAR has the right of first refusal and must be notified first of any decisions regarding placement of the animal.
I/we agree to give STAR reasonable time to find the animal another foster home and understand that this may take several weeks if not months. I/we agree that I/we may never surrender the animal to an animal shelter that euthanizes surplus pets. I/we agree that I/we may not euthanize the animal except in the case of the animal’s terminal illness, injury, or old age accompanied by pain and suffering. *The euthanasia must be performed by a licensed veterinarian in a private clinic or hospital.
I/we agree to make a serious effort to find the animal if it becomes lost, by immediately (a) filing lost reports with the local police, animal control authorities, animal shelters, SPCA’s and local veterinarians, and (b) posting lost animal signs, and (c) contacting STAR immediately should the animal become lost.
I/we agree never to have this animal undergo elective surgery, such as “de-barking,” or other cosmetic procedures except in the circumstance of a veterinarian’s opinion for medical reasons, without first contacting STAR, and receiving written permission to do so.
I/we will allow STAR to examine and inquire about this animal at any time, and I/we will relinquish this animal without recourse immediately should I/we violate the preceding conditions.
STAR shall not be held responsible for any bodily injuries or property damage caused by this animal or by the actions of his/her adopted owners. I/we specifically assume sole responsibility for, and agree to hold the above named organization and its members harmless from any and all loss and expenses, including legal fees, by reason of liability imposed by law.
I agree that all statements I have made on this form are true. If it is found that any statements I have made on this form are not true the adopted animal can be confiscated.