FOAC Dog Adoption Application and Agreement
Adoption Agreement
Name(s) of Adopter(s) *
Your answer
Date *
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Address: *
Your answer
City, State, Zip *
Your answer
Home Phone *
Your answer
Cell Phone *
Your answer
Work Phone *
Your answer
Email *
Your answer
Driver's License *
Your answer
Driver's License State *
Your answer
Do you currently have pets? *
If so how many? *
Your answer
Description of pets *
Your answer
Veterinarian *
Your answer
Veterinarian Phone *
Your answer
Adoptable dog name *
Your answer
Gender *
Age *
Your answer
Altered? *
Breed *
Your answer
Color(s) *
Your answer
Where did you see or hear about this dog? *
In regards to the adoption of the above-described Dog from Friends of the Animal Community (hereafter called FOAC), I/we, the undersigned, agree to the following conditions: please initial *
Your answer
1. To assume all legal risks and obligations of ownership and to agree to hold FOAC, its officers, board members, agents and volunteers harmless for any loss of, damage to, or injury to person, animals, or property arising from or relation to the adoption of this dog. Please initial. *
Your answer
2. To guarantee that this dog will be altered by (fill in below), if already not done. I understand that the adoption is conditional and not final until this dog is altered. In the event that I/we fail to alter this dog and provide proof of sterilization as performed by a veterinarian by the date specified below, full ownership of this dog would revert back to FOAC upon demand by a FOAC agent. *
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Initial *
Your answer
3. To keep this dog in my possession and not to give away, sell or abandon. Please initial. *
Your answer
4. To supply adequate quantities of a good quality dog food and fresh, clean water daily. Please initial. *
Your answer
5. I/we agree that if at any point we cannot keep the dog, I/we will relinquish custody and return him/her to FOAC without requesting a fee. Please initial. *
Your answer
6. To provide a safe, clean environment with a securely fenced yard. Please initial. *
Your answer
7. To not permit this dog to be used for vivisection or experimentation. Please initial. *
Your answer
8. To keep this dog currently licensed as required by county ordinances and/or state law. Please initial. *
Your answer
9. To respect and comply with all applicable animal control laws and ordinances imposed by the county and state governments. Please initial. *
Your answer
10. To allow FOAC agents to inspect my home, both prior to and after adoptions. Please initial. *
Your answer
11. To pay the requested adoption fee (payable to FOAC). I/we understand this adoption fee is non-refundable. Please initial. *
Your answer
12. To give my/our permission for a FOAC agent to remove this dog from my custody if this dog is being neglected, abused, or has not been altered as agreed, and entry to our property shall not constitute a trespass up on the premises occupied. Please initial. *
Your answer
13. I/we authorize the Tuolumne County Animal Control to conduct a background check including but not limited to past contacts by Animal Control with me or other individuals at my current or former addresses and impound, licensing and veterinary history on animals currently or previously owned by me. I authorize the sharing of veterinary medical information regarding my animals between veterinarians and Tuolumne County Animal Control and release said veterinarians from any liability for providing this information. Please initial. *
Your answer
IMPORTANT NOTICE: Every effort is made to place only healthy dogs. FOAC cannot guarantee the health of any animal adopted from us, and FOAC assumes no responsibility for any medical bills incurred from a private veterinarian. Please initial. *
Your answer
Adopter(s) Names: *
Your answer
FOAC Agent Name:
Your answer
Internal Use Only: FOAC Intake Date
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Microchip Number
Your answer
Home Inspection Date
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AC or Community Dog
AC Chameleon #
Your answer
FOAC #
Your answer
Approved or Not Approved
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