Adoption Agreement
No part of this form may be duplicated or reprinted in any media without the express written consent of Merlin's Refuge.
All information is confidential and proprietary to Merlin's Refuge
NOTE: This is a sample of the form that each adopter will be asked to complete and sign.
You cannot complete and submit this form online. It is intended to review only and to give prospective
adopters a chance to review the information we will require at the time of adoption.
Pet's Name:
Breed:
Color and Description:
Sex:
Age:
Neutered:
Date to Neuter: (mm/dd/yy)
Remarks:
Name of Adopter:
Phone Number:
Address:
City:
State:
Driver's License Number:
As the adopting party I agree to the following provisions:
- I understand that only neutered animals are released for adoption
- I agree to provide the adopted animal with necessary inoculations at the intervals advised by my
veterinarian.
- I agree to have the adopted animal under my control when it is not within the confines of my property. A secure, fenced area will be provided for dogs, including shelter from the elements. The adopted animal will not be tied or chained.
- I agree not to abuse or neglect the adopted animal.
- If I am adopting a cat, I agree not to de-claw it, which would render it defenseless.
- I understand that Merlin's Refuge cannot guarantee the health,
temperament, or training of the above described animal, and hereby release
Merlin's refuge from all liability.
Signature of Adopter:
Date:
Signature of Staff Member: