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Adoption Application & Agreement Form
PHOTO ID REQUIRED-TARZAN'S SAFE HAVEN MUST KEEP A COPY

Our goal at Tarzan's Safe Haven is to match up each pet with the correct adoptive family to insure a safe and healthy forever home. Please help us by filling out this application completely and to the best of your ability. We reserve the right to refuse any adoption we may consider unsatisfactory. A refusal to an adoption may not mean another adoption would not be a better match for both the pet and you.

Full Name & Age
Your answer
Names & Ages of Everyone in the Household
Your answer
Address
Your answer
Cell & Work Numbers
Your answer
E-Mail
Your answer
Employer Name & Occupation
Your answer
Reference Name & Number
Your answer
How did you hear about Tarzan's Safe Haven?
Your answer
Will you and all other adults in your household consent to a background check?
Will you agree to have a home visit from staff or volunteers from Tarzan's Safe Haven before and after the adoption process to insure the safety and health of your adoptive pet and your family?
List all pets in your household in the last 5 years: Include type, sex and age
Your answer
Are they spayed or neutered?
Where are they now?
Your answer
Are you willing to bring your current pets to meet the new potential adopted family member?
Have you ever owned this type of pet before?
Why do you want to adopt an animal?
Your answer
Does anyone in your household have animal allergies? If yes, what kind?
Who will be responsible for feeding, exercise, housebreaking and training?
Your answer
How many hours a day will this pet be alone?
Your answer
Where will this pet be kept when home alone?
Your answer
Where will this pet sleep?
Your answer
How many hours a day do you plan on spending with your pet? Doing what together?
Your answer
Will your pet spend most of their time indoor or outdoor?
Do you have a fenced in yard? What type of fence and how tall?
Your answer
Have you ever relinquished a pet before?
If yes, explain the circumstances
Your answer
What are acceptable reasons for relinquishing?
Your answer
If you can no longer keep this pet what would you plan to do?
Your answer
Will you consent for photo usage of you and your family to be used for awareness purposes at the digression of Tarzan's Safe Haven?
You will most likely be receiving follow up calls to insure your new adoptive family member and the rest of the household are adapting well. Will you be open to talking with us?
Tarzan's Safe Haven Pet Adoption Agreement
The Adoptive Family Understands & Agrees To The Following:
Adopter is 18 years of age or older
Adopter understands the stress of changing environments can lower an animals immune system and your pet could receive an infection without displaying any symptoms. We cannot guarantee or be help liable, financially, medically or otherwise for the health of any animal. If know by Tarzan's Safe Haven, any diagnosed conditions with further treatment plans will disposed to the adopter. The adopter will be responsible for all medical, behavioral treatment as of the adoption day.
Adopter agrees to take the animal into a veterinarian within 14 days of adoption for a general checkup, including but not limited to vaccinations, deworming, medication or medical treatment at adopters own expense. Adopter agrees that if the animal is not spayed/neutered adopter will have that procedure complete within 4 weeks of the adoption, or of appropriate age, and will provide the paperwork of the completed procedure to Tarzan's Safe Haven within those 30 days.
Adopter agrees to provide the animal a humane environment, including but not limited to regular exercise, medical needs and checkups, food, water, mental and physical stimulation and companionship. Adopter agrees to inoculate the animal against rabies and abide by animal control laws.
Some matches may not be as successful as we all hope for. Tarzan's Safe Haven will welcome back your pet at any point in time. In the event you can not keep the animal, Tarzan's Safe Haven must be notified and given first option to receive the animal back. We are a non for profit organization and we cannot refund your adoption fee after 14 days. In the event the animal is returned due to health issues found within the first 14 days Tarzan's Safe Haven will welcome back the animal and will refund the adoption fee, the adopter will not be refunded for any medical bills.
Adopter understands and agrees that Tarzan's Safe Haven makes no express or implied warranty, representation or promise to age, health, breed, habits, sex, disposition, or safety of the animal. Adopter accepts the animal as is, assume all risks and responsibilities associated with ownership of an animal, including but not limited to bites, bodily injury, personal injury, illness, death, or property damage, and adopter releases Tarzan's Safe Haven, their employees, volunteers, and all associated persons and companies of any and all liability.
The adopter acknowledges that if the terms and conditions are not appropriately followed, Tarzan's Safe Haven may retrieve the animal(s) back without reimbursement. Adopter acknowledges that they have read and fully understand the terms and conditions of the adoption waiver and agreement and will comply with the same.
Please Type Your Full Name As A Digital Signature of Acceptance and Date Below
Your answer
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