EmailMe Form - ADOPTION APPLICATION

Name of the pet you are adopting *

Breed *

Age *

Gender of dog *

Microchip ID number, if known

Altered? *

Adopter's name *

First Last

Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone *

### - ### - ####

Cell Phone

### - ### - ####

Email *

Drivers License Number *

Type of housing you reside in *

Do you rent this property? *

If yes, please list landlord's name

Landlord's phone

### - ### - ####

Do you have a fenced-in yard? *

Why do you want to adopt this pet? *

Do you have any children? *

If yes, please add ages of children

Separate the ages with commas

Have you previously owned a dog? *

Do you have any other pets? *

If yes, please list type of animal and age.

Will you be using a crate for the purpose of fostering and/or training? *

Primary Veterinarian

Phone

### - ### - ####

REFERENCES

List two references that if contacted, would be able to attest that you indeed provide proper care and love to your pets.

Reference 1 Name *

First Last

Reference 1 Phone *

### - ### - ####

Reference 1 Email

Reference 2 Name *

First Last

Reference 2 Phone *

### - ### - ####

Reference 2 Email

OutDoors

What Percentage of Time is the pet going to spend outdoors alone?

Indoors/Outdoors *

Are you willing and able to provide your pet with monthly heartworm prevention and yearly vaccinations? *

If no, please explain why:

By submitting this document, (the applicant listed under "adopter") agrees to be the new, delegated owner & to take full financial responsibility for this pet both in its current & future life events. This dog is not to be given away without first notifying One By One Dog Rescue. In the tragic event that this pet can no longer be cared and no other responsible home can be found, the pet is to be returned to One By One Dog Rescue, Inc; under no circumstances is the dog to be surrendered to a kill shelter. Surrendering the dog to a kill shelter constitutes as a breach of contract and a $300 penalty. In addition, the adoption fee is not refundable. If the dog gets lost you may contact our non-profit to help you in your search for your lost pet. One By One Dog Rescue, Inc. cannot guarantee full grown size of puppies that are adopted through our rescue; we can only provide our best estimates based on the current size of a puppy. We cannot guarantee temperament or behavior of any dog; our information regarding the temperament or behavior of every dog within our rescue is limited to basic observations and evaluations during the amount of time we have interacted with the dog while in Miami Dade Animal Services and/or in foster care. The applicant further agrees to hold harmless One By One Dog Rescue for any actions the dog may commit after he/she is adopted; including but not limited to any injuries inflicted by the dog on another animal, any injuries inflicted by the dog on another human being, or any destruction of furniture or other items within the adopter household. Moreover, One By One Dog Rescue, Inc. is not to be held liable for any illness or parasite discovered after adoption, including but not limited to internal or external parasites, cancer, mange, distemper, and/or parvovirus. *

I Agree

I Disagree