CRESTON PET ADOPTION & WELFARE SOCIETY

Box 253,

Creston, B. C. V0B 1G0

Phone: 250-428-7297 Fax: 250-866-5475

Email: paws@kootenay.com Website: www.crestonbc.com/paws

CAT ADOPTION APPLICATION

PART A - DESCRIPTION OF PET

Paws Tag No.

Which cat are you interested in adopting?

If you are not interested in a specific cat, please indicate what characteristics you are most interested in (eg. Age, gender, personality. . . .)

 

PART B - APPLICANT INFORMATION

Date:

Full Name:

Residential Address:

Mailing Address:

Phone - Home: Work

Name of Veterinarian:

Address:

Phone:

What type of building do you live in (ie. house, apartment, etc.)? _____________________

Do you Rent _____ Own _____

If you rent does your landlord know that you plan to adopt a cat? Yes _____ No _____

Landlord contact information: _________________________________________________

Where will the cat be housed?

Indoors ___ Outdoors ___ Other (please explain):

 

 

Does everyone in your household agree with adopting a cat? Yes _____ No _____

Is any household member allergic to cats? Yes _____ No _____

Is any household member afraid of cats? Yes _____ No _____

Does any household member smoke? Yes _____ No _____

Do you have children? ___________ Number _____ Ages _____________

How much contact with the children will the cat have?

Frequent _____ Occasionally _____ Seldom _____

How would you describe your child(ren's) behavior around animals?

______________________________________________________

Have you owned pets before? Yes _____ No _____

What happened to those pets?__________________________________________

Describe any other pets you may have now:

 

Are they spayed/neutered? Yes _____ No _____

Do you support spaying and neutering? Yes _____ No _____

Why do you want to adopt "this" cat? _______________________________________

 

Please name at least two (2) non-related personal references who do not share your premises that we may contact:

Name: Relationship:

Phone/Email:

Name: Relationship:

Phone/Email:

Name: Relationship:

Phone/Email:

 

RELEASE OF LIABILITY AND INDEMNIFICATION

 

I/WE, (Name, address and telephone number): _____________________________________

_______________________________________________________________________

HEREBY AGREE TO THE FOLLOWING:

  1. To care for this cat humanely (including providing adequate food, water, shelter, love and attention). Cat shall not be left outside to roam at will.

    2. (initial) ____________

  2. This cat will not be isolated. It shall not be confined to a pen, room, basement or other enclosure. (initial)______________.

    3.  

  3. This cat shall be loved, respected, and included in its family circle.

    4. (initial)_____

  4. To give reasonable protection of this cat from the uneducated behaviour of children and adults, and conversely, of children and adults from this cat. I understand and acknowledge that this cat has been tested for dog/cat aggression and will be sensitive and diligent regarding the safety of other animals and people: and that I will assume all risks associated with this assessment.

    5. (initial) ____________

  5. To vaccinate annually with necessary inoculations as local ordinances require.

    6. (initial) ____________

  6. To provide necessary and essential veterinary care, as required.

    7. (initial) ____________

  7. To notify the Creston Pet Adoption and Welfare Society if said cat becomes lost or stolen.

    8. (initial) ____________

  8. To have said cat spayed/neutered within 4 months of adoption if not already done (i.e. cat was too young to spay/neuter when adopted).

    9. (initial) ____________

  9. Not to sell, trade or dispose of this cat. If, at any time, I/We are unable OR unwilling to care for this cat, I/We agree to contact and return said cat to Creston Pet Adoption and Welfare Society. (initial) ____________

  10. This cat shall not be euthanized without Creston Pet Adoption and Welfare Society permission, except under extraordinary circumstances.

    11. (initial) _______

  11. This cat shall not be euthanized for reasons of behaviour.

    12. (initial)_______________.

  12. The adoption fee of ________________($______)_ DOLLARS will not be refunded after 10 days from the adoption date. I/We also agree that the Creston Pet Adoption and Welfare Society will keep 25% of the adoption fee, if the cat is returned within the 10-day period.

    13. (initial) ____________

  13. That the said cat shall not be used for medical or any other experimental purposes or sold or given to a pet store, supplier or wholesaler.

    14. (initial) ____________

  14. That we will notify the Creston Pet Adoption and Welfare Society within 10 days of any change of address or phone number.

    15. (initial) ____________

  15. It is also understood that the Creston Pet Adoption and Welfare Society cannot be held responsible for any health or temperament problems that may develop following the adoption of said cat.

    16. (initial) ____________

  16. It is further understood that the Creston Pet Adoption and Welfare Society may examine and make inquiries about said cat at any time. If not satisfied with the condition of the cat or the conditions in which it is kept, said cat can or may be removed immediately and placed in a different home. Any veterinary services needed due to negligence or lack of care will be the responsibility of the adopter and payable to the Creston Pet Adoption and Welfare Society.

    17. (initial)_______

  17. This cat shall not be transferred to any other person without written permission of the Creston Pet Adoption and Welfare Society. We may very well approve of a new family if you must give up your cat for any reasons, but we must screen them just as we screened you, and the new family must sign our adoption agreement. We will take back any cat at any time.

(Initial)_________

 

 

I/We promise and agree to be solely responsible for this animal, and to indemnify and hold harmless the Creston Pet Adoption and Welfare Society from any and all claims of liability for the conduct of this animal on or after the date of this adoption.

 

This Release of Liability and Indemnification shall apply to all known, unknown and anticipated damages resulting from my/our adoption, ownership and control of this the said cat.

 

I/WE HEREBY ACKNOWLEDGE that I/We have read and understand the above terms and conditions and will keep the cat described herein as a family member, with all the rights and privileges attached.

 

SIGNED: Creston Pet Adoption and Welfare Society:

____________________________________ Per: ________________________________

____________________________________ Per: ________________________________