Dog Name:
Color: Sex:
Age:
1. The Adopter shall take the animal to a veterinarian within one (1) week of the date of this contract for a check-up, medication, and treatment recommended by the veterinarian. Proof of this first veterinary visit is required and will be furnished to Second Chance by the end of the second week. Second
Chance Dog Rescue (SCR) makes no representation or warranties as to the health of the dog. This contract will serve as a release for this information from the vet where the vet is seen if such information is not provided to
Second Chance Dog Rescue.
. (Adopter(s) Initials)
2. Since the animal comes from an unknown genetic background, the Adopter will not hold SCR liable for any medical problems such as with eyes, hips, heart, etc.
(Adopter(s) Initials)
3. If the animal is over four (4) months of age and has not been previously spayed/neutered, the Adopter shall have the animal surgically sterilized within two (2) weeks from the date of this contract. If the animal is less than four
(4) months of age, I/we agree to have the animal surgically sterilized within two (2) weeks of the animals turning four (4) months of age. Adoption of the animal DOES NOT become final until the Adopter delivers proof that the animal has been spayed or neutered to SCR. In the case of unsprayed females, if the animal produces a litter prior to spaying, the litter and the female dog become the property of SECOND CHANCE DOG RESCUE.
PURSUANT TO SECTION 3.1-796.126:2 OF THE CODE OF VIRGINIA,
STERILIZATION AS PROVIDED FOR HEREIN IS REQUIRED UNDER THE
LAW, AND THE ADOPTER IS FURTHER REQUIRED TO FURNISH
PROOF OF COMPLIANCE TO SCR WITHIN SEVEN DAYS OF
STERILIZATION. ANY PERSON VIOLATING THIS SECTION OF THE
CODE OF VIRGINIA IS SUBJECT TO A CIVIL PENALTY.
(Adopter(s) Initials)
4. The Adopter shall provide the animal with humane care and maintain it in accordance with all current and future state, county and municipal laws and ordinances where the Adopter resides.
(Adopter(s) Initials)

5. The Adopter shall provide the animal with necessary veterinary care upon sickness, disease, injury or aging, and shall take it to the veterinarian at least annually (once a year) for a health examination and to provide the animal the following shots: DHLPP-C, rabies, heartworm test and prescribed preventative medication to include heartworm preventative, and fecal parasite test and treatment as necessary.
_________ ____________(Adopter(s) Initials
6. The Adopter agrees to keep Second Chance Dog Rescue as the second contact for the microchip company and the adopter will alert Second Chance
Dog Rescue in the event that they move. The owner also agrees to contact
Second Chance Dog Rescue if the dog(s) becomes lost or stolen.
_________ ____________(Adopter(s) Initials
7. The Adopter shall provide the animal with a securely fenced yard or other humane means of exercise. The animal shall not be kept constantly chained or tied up outdoors, or allowed to run at large, nor shall it be kept outside when the residence is unoccupied.
_________ ____________(Adopter(s) Initials
8. If the animal cannot be kept by the Adopter, the Adopter must return it to
SCR . The animal SHALL NOT be given away, sold or exchanged without the prior written permission of SCR. In the event of the Adopter death, SCR shall be notified immediately. The Adopter agrees to pay all expenses relating to the return of said dog.
_________ ____________(Adopter(s) Initials
9. The animal shall reside at and live inside the Adopter dwelling.
_________ ____________(Adopter(s) Initials
10. The Adopter shall keep the animal as its own household pet, and shall not use it for breeding or exclusively as a guard dog or hunting dog.
_________ ____________(Adopter(s) Initials
11. The animal SHALL NOT BE USED FOR RESEARCH.
_________ ____________(Adopter(s) Initials
12. The Adopter shall provide the animal with and ensure the use of a collar and personal identification tag for the animal to wear at all times when allowed to go outdoors.
_________ ____________(Adopter(s) Initials
13. The adopt fee is non-refundable.
_________ ____________(Adopter(s) Initials
14. The Adopter, from the date of this contract, agrees to release and indemnify
SCR from any and all claims, known and unknown, now or hereafter arising in connection with the animal.
_________ ____________(Adopter(s) Initials

15. The Adopter consents to the examination of the animal by SCR at any time.
The Adopter also consents to reclamation of the animal by SCR at any time for failure to comply with the terms of this contract or for any misrepresentation of fact made by the Adopter on the SCR ADOPTION
APPLICATION.
_________ ____________(Adopter(s) Initials
16. The Adopter agrees to pay SCR for any and all expenses, including court costs and reasonable attorney fees, in enforcing the terms and provisions of this contract.
_________ ____________(Adopter(s) Initials
17. The Adopter and SCR agree that the actual value of this animal is $275.00 for non-microchipped dogs and $285.00 for microchipped dogs
_________ ____________(Adopter(s) Initials
18. This contract will be governed by and construed under the laws of the
Commonwealth of Virginia without regard to conflicts of law principals.
_________ ____________(Adopter(s) Initials
19. This contract becomes void if any changes are made by the adopter without prior consent by SCR.
_________ ____________(Adopter(s) Initials
20. I/We understand that any misrepresentation of information provided will nullify this contract.
_________ ____________(Adopter(s) Initials
I/We (the Adopter), do this day of
, enter into this ADOPTION CONTRACT and acknowledge receipt from SCR of the custody of the animal named and described as
Name
Breed
Age. Sex
Distinguishing marks.
(Altered Yes No),
(The animal).
I/We acknowledge having read and agree to abide by each of the eighteen (18) rules for
Adoption set for herein.
Signed
Date
Print Name(s)
Print Address
City, State, Zip Code

Home Phone work Phone email
Drivers License Number/State
Witnessed:
(signed by SECOND CHANCE DOG RESCUE (representative, date, print name)

ADOPTION RELEASE
Second Chance Dog Rescue (SCR) and its representatives ACCEPT NO
RESPONSIBILITY FOR DAMAGE OR INJURY caused by the adopted dog named below.
(Adopter(s) Initials)
While every effort is made to provide accurate history and assessment of a dog, SCR and its representatives DO NOT WARRANT THE DOG DESCRIBED BELOW
REGARDING PRESENT OR FUTURE MEDICAL CONDITION OR TEMPERAMENT.
(Adopter(s) Initials)
Color
Dog name
Age Sex
Distinguishing marks
Signature of Adopting Party
Printed Name of Adopting Party
Signature of Adopting Party
Printed Name of Adopting Party
Date
Date
Signature of SCR Representative Date
Printed name of SCR Representative
ACKNOWLEDGEMENT OF AND ASSUMPTION OF THE RISK FOR POTENTIAL OR
ACTUAL AGGRESSIVE BEHAVIOR
The dog described as (name) , age , sex
, may exhibit or has exhibited aggressive tendencies as described below.
Although it is possible that this dog exhibits aggressive tendencies only in certain situations, no assurance is given.
(Initial(s) of adopting party)

The signature of the adopting party or parties below operates as verification by the adopting party or parties that EACH INCIDENCE DESCRIBED ABOVE OF ACTUAL
OR POTENTIAL AGGRESSIVE BEHAVIOR BY THE ADOPTED DOG NAMED
HEREIN IS KNOWN AND UNDERSTOOD by the adopting party or parties.
(Initial(s) of adopting party)
Moreover, the signature of the adopting party or parties below operates as verification that THE ADOPTING PARTY OR EACH OF THE ADOPTING PARTIES
VOLUNATIRLIY AND KNOWINGLY ASSUMES THE RISK OF INJURY TO
HIMSELF/HERSELF, HIS/HER FAMILY, AND OTHER PERSONS TO WHOM HE/SHE
OWES A DUTY RESULTING FROM SUCH BEHAVIOR BY THE ADOPTED DOG
NAMED ABOVE.
(Initial(s) of adopting party)
Finally, the signature of the adopting party or parties below operates as CONSENT TO
RELIEVE SECOND CHANCE RESUCE AND ITS VOLUNTEERS OF ANY LIABILITY
AND/OR OBLIGATION OF CONDUCT OF THE ADOPTING PARTY OR PARTIES AS
RELATED TO ANY ACTUAL OR POTENTIAL AGGRESSIVE BEHAVIOR EXHIBITED
HEREAFTER BY THE ADOPTED DOG NAMED ABOVE.
(Initial(s) of adopting party)
Date Signature of Adopting party
Printed name of Adopting Party
Signature of Adopting Party
Printed name of Adopting Party
Date
Signature of SCR Representative
Printed name of SCR Representative
Date