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Maggie Lu's Safe Haven Adoption Form
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Email *
Please describe the preferred animal you are willing to adopt. (Breed, Sex, Color, Age, Activity Level, Size, etc.)
Person Information
Full Name *
Current Address *
Housing *
Daytime Phone *
Alternate Phone
Email *
How long have you lived at your current residence? *
Are there any HOA/Rental restrictions or policies regarding pets? *
Do you have other pets? Please list type, age and breed.
Which Veterinarian do you currently use?
Do you work from home or is someone home during the day? *
If no, what are your plans for the new pet while you are away working?
How many hours will the new pet be alone per day? *
Terms & Agreements
1. I understand that I am adopting this animal with the following diagnosed condition or fault, and I realize that this animal may need further training or treatment. Please include diagnoses/issue in your response, N/A if there are no issues. *
2. I will take the animal to a veterinarian within 7 days of adoption for a general physical examination and any necessary vaccinations, deworming, medications or medical treatment, at my own expense. Maggie Lu’s does not reimburse for medical bills once adoption fee has been paid. Maggie Lu’s strives to provide you with a healthy pet but we cannot guarantee the health of any animal. A rehoming fee of $75 will be taken, if adopted and returned before the 7 days. Once the 7 day grace period is up, and the dog is returned, the full adoption fee will not be returned. *
3. I will provide a humane environment, regular exercise and companionship for my pet. I will have the animal inoculated against rabies and provide monthly heartworm prevention and abide by animal control laws. *
4. I understand that, under no circumstances, am I allowed to re-home or surrender this pet without prior approval from Maggie Lu’s Safe Haven Rescue, Inc. *
5. I understand and agree that Maggie Lu’s makes no express or implied warranty, representation or promise to the age, health, breed, habits, disposition or safety of the animal. I hereby accept the animal as is, assume all risks and responsibilities associated with the ownership of the animal, including bites, and I hereby fully and completely release, indemnify and hold harmless Maggie Lu’s Safe Haven Rescue, Inc., its directors, officers, volunteers and employees from any claim, cause of action or liability of any sort or nature, whether known or unknown, directly or indirectly arising out of or in connection with the adoption, care or ownership, maintenance, temperament or condition of the animal. *
6. I understand Maggie Lu’s adoption fee to be $390 which includes shots, spay/neuter, any necessary vetting, and microchip. *
I acknowledge that I have read and fully understand the terms and conditions of the foregoing adoption contract and that I will comply with the same. Please type full name and date.
A copy of your responses will be emailed to the address you provided.
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