I, _______________________, the undersigned (hereinafter referred to as
Agree to the conditions set forth by the Southwest Cairn Rescue, (hereinafter
referred to as AGENT) in this agreement for the
adoption of the dog known as _____________________, described as
year(s) old, ____ (gender), _______ colored Cairn Terrier (hereinafter referred
to as TERRIER).
The ADOPTER agrees to provide adequate shelter, food and all necessary
care and further agrees that the rescued terrier will not be allowed to run free
without direct and proper supervision. Failure to do so will require that the
TERRIER be surrendered to the Southwest Cairn Rescue, Agent.
As of ________________ (date), the ADOPTER, as the new owner accepts the
responsibility for the actions and behaviors of the above-described dog,
previous owners and/or agents from all liability, and acknowledges and agrees to
following conditions of adoption:
• The TERRIER must be given adequate time to adjust to it's new surroundings
it's new owners.
• The Southwest Cairn Rescue Agent will be contacted immediately for
assistance and/or counseling if any problem(s) should arise.
• If for any reason, the adoption is not found to be satisfactory for the
and/or the ADOPTER, the TERRIER must be returned to the Southwest Cairn Rescue
• The ADOPTER may not sell or give the TERRIER away to anyone else.
• Periodic follow-up telephone calls will be made by the Agent to be assured of
all terms of the agreement.
• The Agent reserves the right to inspect the conditions and care of the TERRIER
at any future date and reserves the right to confiscate said TERRIER if
or otherwise improperly cared for. No refund of any adoption fee will be made
returned or confiscated terriers.
The adoption donation is $________. This donation is used to cover rescue expenses,
including foster care costs and veterinary bills incurred by Southwest Cairn
rescued terrier has been examined by a veterinarian, received a heartworm test
where indicated, received any necessary inoculations, and been
dewormed as necessary. All rescue terriers are spayed or neutered, if of age to
have such procedures preformed, before placement in the ADOPTER'S home.
The AGENT will provide all documents pertaining to the TERRIER, including
registration papers, or per recording papers and any veterinarian records, to
Additional information about the TERRIER:
Specifically, the ADOPTER agrees to:
01. Provide proper and sufficient food, water, shelter and kind treatment for
terrier at all times.
02. Have the terrier immunized and examined annually, at my expense.
03. Keep the terrier current on heartworm preventative.
04. License the terrier in the city or town in which the ADOPTER resides.
05. Have the terrier spayed or neutered, if immature at the time of the
The ADOPTER understands that failure to do so will result in forfeiture of
deposit and, upon demand, return of the terrier to the Southwest Cairn
06. Not sell or abandon the terrier.
07. Return the terrier to the Southwest Cairn Rescue Agent if for any reason
is found to be unsatisfactory.
08. Allow periodic inspections of the terrier, the ADOPTER'S residence and
living conditions provided for the terrier by the
Southwest Cairn Rescue Agent.
09. Inform the Southwest Cairn Rescue Agent of any address and/or telephone number
10. Not allow the terrier to be used for the purpose of vivisection or
11. Not permit the terrier to run at large or to become a public nuisance.
12. Keeps means of identification on the terrier at all times.
13. Immediately retrieve the terrier from any public pound or animal shelter
notified the terrier is being held at such location.
14. Notify the Southwest Cairn Rescue Agent immediately if the terrier is lost,
15. Provided suitable confinement for the terrier. Under no circumstances is
animal to be routinely tethered as a means of confinement.
16. Keep the animal protected on a leash when outside proper confinement.
17. Arrange for suitable care if the owner will be on a prolonged absence
18. Assert no claim, charge or demand of any kind against Southwest Cairn
it's Agent for any expenses that have been incurred by the ADOPTER,
veterinary fees, in connection with the animal.
19. Accept sole responsibility for any illness or injury occurring after
20. Accept this terrier as is, assume all risk of ownership of the
including risk of injury or damage caused by the terrier, including bites.
I FULLY AND COMPLETELY RELEASE SOUTHWEST CAIRN RESCUE AND IT'S AGENT
FROM ANY CLAIM, CAUSE OF ACTION OR DEMAND OF ANY SORT OR NATURE AS A RESULT OF
ADOPTION, OWNERSHIP, CARE, MAINTENANCE OR RETENTION OF THE TERRIER.
I ACKNOWLEDGE THAT I HAVE READ AND FULLY UNDERSTAND THE TERMS AND CONDITIONS
THE FOREGOING ADOPTION AGREEMENT AND THAT I WILL COMPLY WITH THE SAME.
Printed Name:___________________________________ Work
Rescue Administrator's Signature: