Rescue Pit Bulls Adoption Form
Fill out this form and we will be in touch as soon as possible. *Submittal of this application does not guarantee approval for adoption.
Email address *
Your full name
Your answer
Date
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DD
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YYYY
Name of dog you are interested in adopting:
Your answer
Your full address
Your answer
Home Phone
Your answer
Cell Phone
Your answer
Occupation
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Marital Status
Your answer
Spouses Name
Your answer
Your age group
Have you ever applied for or adopted another dog from Out of the Ashes Pit Bull Rescue before?
If so, please give dogs name and the date the adoption took place:
Your answer
Would you welcome a OOTAPBR volunteer in your house for a home check prior to adoption?
Do you live:
How many adults (21 years or older) are in the household
Your answer
Who will be the primary caretaker of this dog:
Your answer
Do you have children?
If so, what ages?
Your answer
Have they been around dogs before?
Your answer
Have you ever been convicted of a felony?
If yes, please explain
Your answer
By checking YES you agree to absolve Out of the Ashes Pit Bull Rescue and all of its representatives from any liability in reference to a dog featured in this adoption.
Do you prefer
Do you prefer:
If you have a preference in appearance such as color and weight, please describe it here:
Your answer
Do you want a dog for
Additional requirements about the dog you would like to add:
Your answer
Do you live in
Is your home located in an
How long have you lived at your current home?
Your answer
Do you own or rent?
Your answer
If renting do you have permission to have a pet?
Any breed/size restrictions?
Your answer
Square footage of current home:
Your answer
If you are renting, please provide name and phone # of homeowner or landlord:
Your answer
If you own your home, please provide the name of your home insurance carrier:
Your answer
If you move one day (check best response for your situation) :
Does your municipality have Breed Specific Legislations?
Your answer
If yes, do you meet restrictions? specifics are as follows; please explain:
Your answer
OR No Breed Specific Legislations
Your answer
OR Don’t know about BSL
Your answer
Dog’s living situation:
If other, please explain:
Your answer
Approximately how many hours a day will the dog be home alone?
Your answer
When home alone, dog will be:
If other; please explain
Your answer
Do you frequently go out of town (work or leisure)
If so who will care for the dog when you are away?
Your answer
How will you exercise the dog?
Home yard size is:
Is yard enclosed with a fence?
Do you have a doggy door?
If yard is fenced in, please describe fencing (height and type):
Your answer
Do you have other DOGS? (check all that apply)
Please specify breed(s) and age(s) of all other dogs:
Your answer
Please describe other pet(s) living situation (inside, outside, crate, etc):
Your answer
If you have or had other dogs in the past, please let us know their current disposition
What other kind of animals do you have?
Your answer
In your opinion, what is a good reason to get rid of a pet?
If other, please explain:
Your answer
Of all breeds available, why do you want a bully breed dog?
Your answer
Experience: Please describe any prior experience you have had with this breed.
Your answer
What would you do if Breed Specific Legislation was passed in your area?
Your answer
References: Please supply the name and phone number of your current veterinarian, or the one who saw your previous pet(s), with their title identification. If you don't have a vet, please provide the name of your employer, co-worker, or anyone not related to you who can attest to your character. Vet references are preferred.
Your answer
By signing this application, I attest that all questions were answered truthfully to the best of my knowledge. If Out of the Ashes Pit Bull Rescue finds any discrepancies at any time, this could result in the animal’s retrieval or cancellation of the application. I hereby acknowledge that the questions and responses in this application are fully incorporated as set forth within the Adoption Agreement and are a part of the contractual agreement I am voluntarily entering into with the Out of the Ashes Pit Bull Rescue. *Submittal of this application does not guarantee approval for adoption. Sign digitally here:
Your answer
LIABILITY CLAUSE:
IN NO EVENT SHALL OOTAPBR BE LIABLE TO OWNER UNDER THIS AGREEMENT OR OTHERWISE, FOR CONSEQUENTIAL, EXEMPLARY, SPECIAL, INCIDENTAL, OR PUNITIVE DAMAGES INCLUDING, WITHOUT LIMITATION, LOSS OF REVENUE, LOSS OR DESTRUCTION OF PROPERTY, PERSONAL INJURY, DEATH OR DISMEMBERMENT, ANTICIPATED PROFITS OR LOST BUSINESS, OR OTHER DAMAGES, INCLUDING AMOUNTS ARISING OUT OF OR IN CONNECTION WITH THIS AGREEMENT OR THE DOG.

IN ADDITION, TO THE EXTENT PERMITTED BY LAW, IN NO EVENT SHALL OOTAPBR BE LIABLE TO OWNER FOR DAMAGES IN EXCESS OF THE ADOPTION FEE ON WHICH A CLAIM FOR DAMAGES MAY ARISE. THE FOREGOING LIMITATIONS SHALL APPLY TO ALL CAUSES OF ACTION IN THE AGGREGATE, INCLUDING, WITHOUT LIMITATION, BREACH OF CONTRACT, AND BREACH OF WARRANTY, NEGLIGENCE, STRICT LIABILITY, MISREPRESENTATION, AND OTHER TORTS.

AS A MATERIAL CONDITION TO THIS AGREEMENT OWNER DOES HEREBY RELEASE OOTAPBR FROM ANY AND ALL LIABILITY, CLAIMS FOR DAMAGE, INJURY OR OTHER SUCH RELATED CLAIMS WHICH MAY ARISE FROM THE OPERATION OF THIS AGREEMENT OR THE DOG.

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A copy of your responses will be emailed to the address you provided.
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