DANE CRAZY WWW.DANECRAZY.

COM
P.O. Box 50408 Nashville, TN 37205
Please note: Dane Crazys primary interest is not to place pets in a home, but to place them in the BEST POSSIBLE home where they will receive the love and care we feel they deserve, therefore we reserve the right to deny any application based on what we feel is in the best interest of the pet. Please read the legal obligations carefully before signing this binding contract.

Adoption Fees are non-refundable

Todays Date : Name: Address: City: County of Residence: Home Phone: email: Date of Birth What is the pets name you are interested in? Breed: Description/ Coloring: In general are you interested An Adult Dog in

State: Cell Phone: :

Zip:

ID #: Puppy

Are you applying to

Foster with Intent to Adopt

Yes Yes No No

Adopt

Foster only

Is there another adult in the household? Name of 2nd adult in the household: Have all adults in the household agreed to the adoption? Do you have children in your household? Yes If Yes, please provide the first name and age of each child

Cell phone # No
s

If no, do you plan to have children in the future? Yes What would you do with your pet if/when you have a child?

No

Maybe

Is anyone in your household allergic to animals: If yes, how severe is the condition Dog or Cats Does anyone in the household have Asthma, COPD If yes, how severe is the condition? Do you Own your home What type of home do you live in? Single Family Apartment Military Housing

Yes Yes

No No

Rent Mobile Home Town House Duplex Condominium

How long have you lived at this address? If you rent, please provide your landlords name, phone number and e-mail address Name: Tel No: Address: Email: Does your landlord have a size limit for a pet? Yes No If yes, what is the weight limit? Does your landlord have any breed restrictions? Yes No If yes, list *How many pets are permitted at your home per your lease? Do you plan to move in the near future? Yes ( when? What would you do with your pet if you moved?

No

List at least two references (non family members) i.e. neighbor or someone who knows you well You must include a phone number and/or e-mail address for each reference

How will you keep your pet confined to your property? Is your yard fenced? No yard Unfenced yard yard partially fenced yard completely fenced portion of yard completely enclosed by fence enclosed patio What type of fence do you have? Privacy Chain Link Invisible Combination of chain link/ privacy Runner Kennel Garage Enclosed Patio What is the height of the fence? Is your fence in good and working repair? . Yes No I.e. are there holes the pet could get out of, a gate that is missing or does not work, electronic is working properly, etc? Please specify: If you have a non-electric fence, is there a lock on the gate? Yes No Why are you interested in adopting a pet at this time? Any special circumstances you want us to know about? Is this your first experience with this type of pet? Yes No

List all the animals that you currently own or have owned in the past 5 yrs: type, age, spayed/neutered, inside/outside and where they are now. Name Breed mix & weight Age Spayed/Neutered Inside Outside Where is the pet now? 1. Yes No 2. Yes No 3. Yes No 4. Yes No 5. Yes No Are current pets up to date on vaccinations?

Rabies Yearly booster shots flea/tick preventative

Heartworm preventative
Yes No

If your pet becomes ill can you afford the vet bill to heal them (possible $100-$500)

Have you ever given up a pet? (i.e. given to someone, surrendered to a rescue or animal control, euthanized?) Yes No

If yes, please explain.

Yes No Are you familiar with heartworm disease? Please explain? Yes No Would you like information regarding heartworm disease? Can you afford and will you provide monthly heartworm preventative for this dog? (costs range between $25-$40 for a 6-month supply) Yes No Veterinarians Name, address and phone number

If your current vet has been your vet for less than one year, please provide your past vet information to include name, address and phone number. Who in the household will care for the pet? Are you prepared to allow a minimum of 2 weeks for the pet to adjust to your home? Yes Inside only Outside only Inside and Outside Will the animal be kept inside or outside? How much time will the animal spend alone during the day? Where will be animal be kept when you are home? Where will the animal sleep? Where will the animal be kept when you are not home, i.e. working, and on vacation, etc?

No

Describe how you will train your pet? What traits are you looking for in a pet? (please check all that apply) Male Female Baby Young Companion Protective Mouser Companion for another pet How would you react should your pet show aggressive behaviors while eating, to a child, to another pet? Please explain

Are you familiar with the leash and licensing laws in your community?

Yes

No

Dane Crazy is truly a no kill rescue and makes a lifelong commitment to each pet that we place. We are determined that NONE of our animals EVER ends up being abandoned or in a shelter. In order to honor this commitment, this adoption application, once accepted and signed by both the adopter and Dane Crazy shall be considered a binding contract between the adopter and Dane Crazy Rescue. Breach of this contract will result in the adoption becoming null and void and the pet will be returned to Dane Crazy for re-homing. Further legal action may be pursued should it be deemed appropriate by Dane Crazy. Please read this document carefully, and check each statement indicating you understand and agree to this commitment.

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As an adoptive or foster parent for Dane Crazy Rescue, I agree to: For all intents and purposes to give this pet a forever safe and loving home.
I agree NOT to SELL, GIVE AWAY, FORFEIT TO A SHELTER, ABANDON, LIST ON CRAIGS LIST (OR SIMILAR MEDIA), OR TO USE THIS ANIMAL FOR EXPERIMENTAL PURPOSES, ALLOW HIM/HER TO ENGAGE IN DOG FIGHTING OR PURSUE ANY GUARD DOG or ATTACK DOG TRAINING NOW OR AT ANY TIME IN THE FUTURE. IF I AM NO LONGER ABLE TO CARE FOR THIS ANIMAL FOR ANY REASON, THE ANIMAL WILL BE RETURNED TO DANE CRAZY TO BE REHOMED. I WILL BE RESPONSIBLE FOR ANY COST INVOLVED IN RETURNING THE ANIMAL TO DANE CRAZY AND UNDERSTAND THERE IS NO REFUND OF THE ADOPTION FEE. (THE SPAY/NEUTER DEPOSIT WILL BE RETURNED IF THE PET IS UNDER THE AGE OF 6 MOS. OR WAS SPAYED/NEUTERED BY THE AGE OF 6 MOS). I UNDERSTAND THAT IF THE PET IS RETURNED WITH LESS THAN ONE WEEK NOTICE, I MAY BE RESPONSIBLE FOR BOARDING COSTS FOR THAT WEEK. FAILURE TO ABIDE BY THIS CONDITION OF ADOPTION WILL RESULT IN LEGAL ACTION AND ADDITIONAL FEES OF UP TO $500 TO COVER THE COST OF RECOVERY AND OTHER EXPENSES INCURRED TO REHOME THE ANIMAL WILL BE SOUGHT.

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1. I understand if it is determined this pet has not been spayed or neutered because it is too young, I will have him/her spayed or neutered before he/she reaches six months of age. Any adult should be spayed or neutered prior to adoption unless otherwise stated. I understand I am responsible for the COST of this procedure. I understand A SPAY/NEUTER DEPOSIT in the amount of the adoption fee, either by check and/or cash will be provided to Dane Crazy Rescue at the time of adoption for all pets that have not been spayed/ neutered prior to adoption. This deposit is in addition to the adoption fee and will be held uncashed until such time adequate documentation is provided showing that the animal has been spayed/neutered. Once this documentation has been received, the deposit will be returned, un-cashed to the adopter. If this documentation is not received within 30 days of the animal reaching 6 mos of age, the check WILL be cashed and I will be in violation of this agreement and the adoption will become null and void. SHOULD THIS BE A FOSTER TO ADOPT I understand a deposit in the amount of the adoption fee during the one-week foster period is required. The deposit will remain un-cashed until our agreement is finalized. However, should the pet not be returned or the adoption finalized following this foster period the check will be cashed. We shall make every attempt to contact/ locate you prior to cashing the check; however failure to respond to our calls and/or e-mails will violate this contract and may result in legal action. to provide proper and adequate food, water, housing, exercise and grooming for this pet and to treat him/ her humanely at all times (adequate housing is defined as living inside your home, never to be tied or left outside, especially during inclement (ie: above 82degrees or below 32 degrees) or stormy weather). To provide veterinary care in the form of vaccinations, preventative heartworm medications, flea/tick preventative as appropriate, and such veterinary care as is necessary to prevent and/or treat accidents and illnesses. Costs may be from $100 up to $2000.00. My pet will be in a fenced yard, on a leash, or on a large acreage tract. He/she will NOT be tied.

2.

3.

4.

5.

My place of residence in a home, apartment, condo, townhouse, public housing complex or other housing complex allows for ownership and occupancy of the pet I am adopting and the pet will live in my residence. 7. I have been informed that all animals can carry and transmit diseases, some of which affect people including bacteria, viruses, parasites and ringworm ant that these diseases may be undetectable in what appears to be a healthy animal at the time of adoption 8. I am aware that pets may exhibit normal but potentially undesirable behaviors including, but not limited to aggression, house soiling, biting, scratching (people, furniture and woodwork), barking, digging, mounting peoples legs, marking with urine (dogs) and spraying urine (cats), and that these normal behavior patterns may be difficult to manage. No one at this rescue has told me that this pet WILL NOT engage in any of these behavior patterns. I also acknowledge that I will seek training and/or advise regarding any of the above behaviors should they be necessary 9. Dane Crazy Rescue is in NO WAY RESPONSIBLE for any damage the animal may inflict on another person, my property, or the property of another and no attempt will be made by me to hold Dane Crazy Rescue responsible. 10. I am aware that, depending on the size, species, and/or breed, costs to feed, house, train, license and provide health care insurance and/or veterinary care for a pet average between $500 and $1500 per year. I am financially able to meet and will pay these expenses for my adopted pet. I accept the animal as it is at the time of adoption and understand that Dane Crazy Rescue IS NOT 11. responsible for any medical conditions not READILY detected prior to or at the time of this adoption or discovered after such adoption. I release Dane Crazy Rescue from all liability relating to unknown medical issues, temperament, or training of the pet being adopted. 12. I agree that due to the nature of Dane Crazy Rescue being a rescue taking in unwanted animals, the rescue does not always know the exact breed of a dog or the parentage. Dane Crazy Rescue has not guaranteed size or temperament of animal as this is not possible. The rescue can only give you information regarding what we know factually and/ or have acknowledged while in our care 13. I acknowledge a Dane Crazy Rescue representative may make unannounced or unscheduled home visit(s) before, during or after the adoption process to assure the pets well being. If it is deemed the pet is not being well cared for or the adoption contract has been broken, Dane Crazy Rescue representative may enter my property and take possession of the pet.

6.

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14. I have read this agreement and release Dane Crazy Rescue from any presents or future liability associated with my adoption of this pet. I HAVE READ THE ABOVE STATEMENTS AND ACKNOWLEDGEMENTS AND HAVE INDICATED MY AGREEMENT TO EACH. I UNDERSTAND THE RIGHTS AND OBLIGATIONS INVOLVED AND THAT FAILURE TO KEEP THIS CONTRACT MAY RESULT IN LEGAL ACTION AND I WILL BE RESPONSIBLE FOR ALL LEGAL FEES AND COURT COSTS INCURRED BY DANE CRAZY RESCUE. By acknowledging all, I agree to return the pet to Dane Crazy and Dane Crazy only should I decide the pet is not the right fit for me and my family or if I am no longer able to continue to care for this pet for any reason. Signature: ______________________________________________ Printed Name: _________________________________ Date: ____________________

Dane Crazy Rescue representative signature_____________________________________ Date:________ Printed name:__________________________________