Bell's Promise Animal Rescue reserves the right to refuse adoption to any applicant for any reason. This questionnaire becomes part of our contract. No field should be left blank. Please respond in some way to every question on the application form.

• I understand that I am entering into a binding contract with Bell’s Promise Animal
Rescue Inc. 501c3 for the adoption of the above rescued animal. I have read this entire
contract CAREFULLY before signing it.

• I agree that the above animal is being adopted as a family pet. He/she will have extensive
house privileges, will sleep indoors, and WILL NOT be kept primarily in the yard or
kenneled.

• The above animal WILL NOT be kept on a chain.

• I agree to provide the above animal with proper food, water, and shelter.


• I agree to provide the above animal with all necessary vet care and treatment.


• I agree to provide the above animal with MONTHLY Heartworm prevention, as well as
flea and tick preventative.


• If I can no longer keep the above animal, I will notify Bell’s Promise Animal Rescue Inc.
501c3 IMMEDIATELY, so the rescue can reclaim the pet as soon as we can arrange transport and a place for the dog. I understand that under NO CIRCUMSTANCES will I give the animal to a third party or take the pet to a shelter.

• I fully understand and acknowledge that Bell’s Promise Animal Rescue Inc. 501c3 IS
NOT RESPONSIBLE for any injury (human or animal), damage or harm cause by the
above animal. I hereby release Bell’s Promise Animal Rescue Inc. 501c3, and its
representatives, from all liability and financial responsibility from any injury (human or
animal), damage, expense or liability I may incur, relating to the above animal. I agree to
not hold Bell’s Promise Animal Rescue Inc. 501c3 liable from ANY AND ALL such claims
and to pay, without limitation, any costs related to such injury, damage, or liability,
including, in the case of litigation, any attorney’s fees incurred by Bell’s Promise Animal
Rescue Inc. 501c3 in their defense.


• I agree that Bell’s Promise Animal Rescue Inc. 501c3 may make visits at a mutually
convenient time to ascertain that all of the above conditions are being satisfied. If any
representative from Bell’s Promise Animal Rescue Inc. 501c3 contacts me to inquire
about the animal, I agree to make a good faith effort to return their call as soon as
possible. I understand that Bell’s Promise Animal Rescue Inc. 501c3 may reclaim the
above animal at ANY time if, in their opinion, any of the agreed upon conditions are not
being met or they feel that the above animal is not being cared for properly.


• The above animal has been examined by Bell’s Promise Animal Rescue Inc. 501c3 and a
veterinarian prior to adoption and has received all necessary immunizations. However, I
understand Bell’s Promise Animal Rescue Inc. 501c3 does not hold representations or
warranties regarding the animal’s health, physical condition, or age. I understand that
veterinary problems may arise with this animal, and that those problems are solely my
responsibility, as are all related costs once I have adopted the above animal.


• I agree to provide the above animal with proper veterinary care in a timely manner.


• I agree that Bell’s Promise Animal Rescue Inc. 501c3 has informed me of ALL known health and behavior issues and/or problems that the above animal may have. I agree that Bell’s Promise Animal Rescue Inc. 501c3 has informed me of veterinarian’s and shelter staff’s best estimate of the above animal’s age and history


• I understand that the adoption fee for the above animal is NONREFUNDABLE for ANY
REASON!


• I agree to abide by the adoption conditions and realize that I am committed to the above
animal for the remainder of his/her life.