C.A.R.E. Center for Animal Rescue and Education
111 Main St. ,Acushnet, MA 02743
www.caresouthcoast.com
(508) 994- 0220
Dog Foster/ Adoption Application
General Information:
Email Address:________________________________________________
Name:__________________________________ Age:____________ Date:________________________
Address: ________________________________________City:__________________________________
Zip Code:_________________ Work Phone:___________________ Home Phone:___________________
Employment:___________________________________________________________________________
What dog or what type of dog are you interested in fostering/ adopting :
Property Information:
House
I own
If you rent, name of landlord/condominium manager:
Landlord phone:
Spouse/Roommate/Partner’s name (if applicable) Please include last name:
Names and ages of children (if applicable):
Who is the pet for?
Myself
Pet will be kept:
Do you have a yard?
Yes
No
Is it fenced?
Yes
No
If you have no fence, how do you plan to have your new dog relieve/exercise itself?
History:
Have you ever had a companion animal before?
Please list current and other pets you have owned in the past five years:
Pet’s Name
M/F
Spay/Neuter
Age
Still have?
If no, why not?
__________________________
M/F
Y
N
_____
Y
N
___________________
__________________________
M/F
Y
N
_____
Y
N
___________________
__________________________
M/F
Y
N
_____
Y
N
___________________
__________________________
M/F
Y
N
_____
Y
N
___________________
__________________________
M/F
Y
N
_____
Y
N
___________________
Type of Animal
Have you ever surrendered an animal into a shelter?
Yes
No
If yes, please explain:
Have you ever had a pet euthanized?
Yes
No
If yes, please explain:
Who is your current veterinarian or who do you plan to use: ____________________________________
Telephone Number of Veterinarian:_________________________________
Care of Dog:
How many hours each day will the dog be without human company?
When without human company how will the dog be kept?
Free roaming
Tied outside
Crate
Other:
Are you agreeable to having a home check done prior to adoption?
We request a donation depending on the expenses incurred in the dog’s veterinary care. For most dogs the
fee is between $300.00 and $350.00. This includes spay/neuter, vaccinations, heartworm testing, flea/tick
medication, de worming and the first month of heartworm preventative to get you started.
Please realize that dogs need vet care throughout their lives, including yearly boosters, heartworm and
flea/tick preventatives etc. Are you capable of affording to properly take care of this dog?
I confirm all information, and agree to the above:
Adoption Contract
I agree to adopt _____________________________ Date of Birth (approx) ______________
Breed _______________________Gender: M
NM
F
SF
Next vet visit due ________________________ For: ________________________________
C.A.R.E has discussed with me the pet's behaviors and habits. C.A.R.E makes no representation
or warranties whatsoever regarding this pet's condition or behavior. I hereby release C.A.R.E
from any and all loss, damage, expense, claim, or cause of action in any way arising out of or
relating to this pet or to any of C.A.R.Es' efforts to facilitate the rescue and adoption of this
animal.
C.A.R.E has given me a record of this pet's medical history as known. I understand that this pet
has received veterinary care through the C.A.R.E adoption program but undiagnosed conditions
sometimes exist. I understand if this animal is diagnosed with a previously undiagnosed condition
that existed at the time of adoption, I may return this animal to C.A.R.E. for a full refund of the
adoption fee or keep this animal and C.A.R.E will assist with medical finances to the best of its
abilities. C.A.R.E is an all volunteer non-profit organization and runs primarily on donations.
I agree to provide the care and attention necessary to ensure this pet's health and well-being
including:
-good quality food and fresh water,
-indoor shelter
-all routine and emergency medical care.
-routine exercise.
I represent that I am adopting this pet as a companion and personal pet. I will maintain this pet at
my primary residence listed below. I will inform C.A.R.E if I move from the address as stated prior
and can no longer keep the pet.
I agree to obey any applicable vaccination laws and obtain and maintain licenses or permits
relating to this pet as required by law.
I agree to allow a representative of C.A.R.E to visit my residence at a reasonable time to ensure
the terms of this contract are being followed.
I understand that noncompliance of any provision of this contract will constitute a breach of
contract and C.A.R.E shall have the right to demand the immediate return of this pet.
I understand that this is an adoption contract and not a contract for the sale of this pet. The
contract and the application I submitted to C.A.R.E constitute the entire contract for the adoption
of this pet, and no prior representations or agreements are of any force and effect unless
incorporated herein.
I represent that I am at least 18 years of age and I have read this entire contract and understand
all of the representations and conditions.
Signature:
Date
C.A.R.E Representative Signature:
Date: