Lost Angels Adoption Application

NOTE: Please be aware that adoption donations are, without exception, NON-REFUNDABLE.

We need to know as much about you as possible before we consider allowing you to adopt one of our rescues. The information you provide on our application/contract will help us determine the best possible match for you, as well as for the dog. Please answer all questions honestly, as there are no right or wrong answers. Applications that are not completely filled out will be discarded without notice. If a question does not apply to you, fill in the blank with "N/A".

Lost Angels relies on your donations to care for all the homeless dogs in our care. Adoption donations range from $125 to $400. This donation helps defray the costs of veterinary care given to your dog prior to adoption. This care includes, but may not be limited to, all vaccinations, heartworm testing and prevention medication, flea prevention, fecal testing and worming if necessary and surgical procedure for spay/neuter. Your adoption donation also helps to feed, house and provide veterinary care for the dogs still waiting to be adopted, and is NON-REFUNDABLE. You are not buying a dog, you're making a donation. Out-of-state adoptions are acceptable but we do not ship our companion dogs and adopting families must come to Lost Angels to complete the adoption. Sorry, no exceptions.  

Animal Name:  ______________________________________  Gender:   Male   Female

Description:  ________________________________________________________________

Applicant’s Full Name:  ________________________________________________________

Address:  ___________________________________________________________________

City, State, Zip:  ____________________________________

Email Address:  _____________________________________

Daytime Phone:  _______________________  Alternate Phone: _______________________

Please provide reason for wanting a new pet:  ___________________________________________________________________________

Is the pet for:   You          Your Family    Someone else

If someone else, who:  _______________________________

How many hours per day will the animal be left alone?

 Less than 3;  3-5;  5-8;  More than 8

Will the pet be kept  Inside   Outside

Where will your new pet sleep?  _________________________________________________

Have you previously owned other animals?  Yes   No

If yes, list pet(s) name(s) and tell what happened to each of them.

______________________________________________________________________________________________________________________________________________________

Do you currently have other pets?  Yes   No          If yes, how many and what is/are their name(s)? __________________________________________________________________

Are your other pets spayed or neutered?  Yes   No

If no, give reasons:  __________________________________________________________

Are your other pets current on shots, heartworm preventative, vet care?  Yes   No

If not, specify which pets and why not:  ______________________________________________________________________________________________________________________________________________________

Have you ever completed an application for a LAAR animal before?  Yes   No

Do you have children?   Yes   No   Ages:  ______________________________________

Do you work outside the home?  Yes   No

Employer Name:  _________________________________________  Phone:  ____________

Address:  ___________________________________________________________________

Drivers License #:  ___________________________________________________________

Do you  Rent   Own

If you rent, provide name and phone number of apartment complex/landlord:

Name:  ________________________________________________  Phone:  _____________

Address:  ___________________________________________________________________

Do you have a fenced in yard?  Yes   No

What type of fencing:   Wood   Chain Link   Brick Wall   Other:  ________________

How high is fencing:   4 ft   5 ft   6 ft   Other:  _________

Do you have a pool?  Yes   No

What is the name of your current veterinarian?  _____________________________________

Clinic Name:  ___________________________________________  Phone:  _____________

Address:  ___________________________________________________________________

Lost Angels Adoption Contract

This agreement is made between Lost Angels Animal Rescue, Inc. (further known as LAAR) and the adopter. By signing below, you are acknowledging receipt from LAAR, the dog described within the application. Adopting party must be 21 years of age or older and agree to be bound to and comply with the following terms and conditions (if completing online, please check each item; if completing in paper format, please initial each item):

___I understand that a home visit by a LAAR representative is required as a condition of this adoption approval.

___ I understand that written approval AND proof of deposit payment will be required from a landlord as a condition of this adoption.

___ I will have this dog seen by a licensed veterinarian of my choice, at my expense, within 72 hours from the date of this contract. Thereafter, I will have this dog examined at least one a year by a veterinarian and immunized as recommended by that veterinarian, at my expense.

___I will seek appropriate veterinary care and/or treatment for this dog if he/she should become sick or injured.

___I will provide a loving, safe, happy, clean, and gentle home for my new pet at all times.

___I  will provide proper and sufficient food and water for my new pet at all times. I understand that premium pet foods are better for my dog and that certain grocery store brands have been linked to diseases in animals. I will make every effort to provide the best food available at least twice a day (i.e., Nutro, Iams, Eukanuba, etc).

___I understand that I am adopting an indoor dog and will make him/her an indoor member of my family. This animal shall never be maintained outside as a yard dog, and shall never be staked out or chained.

___I will keep my pet parasite and flea-free and will use a veterinarian-recommended product such as Advantage, Frontline, or Revolution monthly. Generic store brands (i.e., Hartz) can be harmful or deadly.

___I will keep my pet on a heartworm preventative recommended by my veterinarian.

___I will not permit this animal to run at large or to become a public nuisance, and will always keep means of identification on him/her at all times. I will immediately retrieve this animal from any public or private facility when notified. In the event this animal becomes lost, I will make every reasonable effort to relocate and claim this animal including notifying LAAR.

___I have been advised to clean my pet's ears and teeth regularly, and to trim his/her nails. I will discuss this with my veterinarian if I have any difficulties.

___This animal will not be transported in an open pickup truck or car.

___No one in my home, including myself, had or now has a pet-related allergy that has not been disclosed to LAAR.

___If I can no longer keep or care for my pet at any time during his/her life, I agree to contact LAAR. LAAR will only be able to take the dog back based on foster discretion and availability. If I return this animal to LAAR for any reason, I will at no time assert any claim, charge or demand of any kind or nature against LAAR for any charges that may have been incurred by me, including veterinarian fees, in connection with this animal.

___I will not use, sell, nor donate my pet for research purposes and understand that ownership of this pet may not be transferred to any other person, firm, corporation or organization for any reason whatsoever.

___I understand that an animal can be unpredictable and that LAAR cannot anticipate or insure against unexpected conduct of an animal adopted from LAAR. I acknowledge that LAAR has not made through its volunteers, any warranties regarding the future condition, temperament or conduct of this animal. I hereby accept this animal as is, assume all risks and responsibilities associated with ownership of this animal, including bites, and I hereby fully and completely release, indemnify, and hold harmless, LAAR, its directors, volunteers, and agents from any claim, cause of action or liability of any sort or nature, whether, known or unknown, directly arising out of or in connection with the adoption, care or ownership, maintenance, retention, temperament, conduct or condition of this animal.

___I agree to communicate with LAAR during the new pet adjustment period to ensure that a mutually satisfactory relationship is established in the new home.

___I agree to allow LAAR to visit my new pet in my home by appointment.

___I agree to make a donation for each puppy/dog adopted. (Donations range from $125 to $400 depending on breed/size.) I understand that a fee of $25.00 and/or immediate return of this animal, as deemed by a LAAR Director, will be incurred upon the receipt of an insufficient check.

___I understand that my adoption donation is non-refundable.

___This contract may be specifically enforceable by LAAR through judicial proceedings, including the right of LAAR to recover the animal due to any breach of any terms of this contract. I hereby agree that in the event I breach this contract and LAAR files suit to enforce this contract or to defend any claims under this contract, I will pay any court costs and attorney's fees incurred by LAAR in connection herewith.

___By checking this box, I understand that this is considered a signed contract.

Signature of Adopter:  _________________________________________________________

Date:  __________________________________

Print Name:  ________________________________________________________________

 

 

Foster Parent signature here: _______________________________________________________________

 

 

Lost Angels Animal Rescue, Inc.

P.O. Box 260212,  Tampa, FL  33685-0212

(813)514-0595

                                                                       www.lostangelsanimalrescue.org