Cocker Spaniel Rescue
of East Texas - Houston
P.O. Box 7326
The Woodlands, Tx 77387-7326
Voice: (281)319-3131

ONLINE ADOPTION CONTRACT

Home Checks Are Done Before Placement
 _________________________________
Cockerkid's Name


_________________________________
Description/Sex


_________________________________
CSR Tag #
Applicant Information

Name: Spouse or Partner's Name:
Names and ages of all persons residing in your home:

Address:
City: State: Zip Code:
eMail: Home Phone: Cell Phone:

Employer:
Address: Work Phone:
How Long?: Occupation:
Spouse Employer:
Address: Work Phone:
How Long?: Occupation:

Own or Rent home? Own Rent House Rent Apartment
If Renting: Is Pet Deposit Required? Yes No                 Is there a size limitation? Yes No
Name and Phone Number of Manager/Landlord: Phone:
Do you have permission from the Manager/Landlord to have pets? Yes No

Fenced Yard? Yes No            Is a swimming pool, spa or other body of water present? Yes No

Name of nearest relative not residing with you:
Address:      Phone:

Information on Current Pets

List the type, breed, age and sex of all pets currently owned.

Where does your present dog spend most of its time
Are all dogs and cats spayed or neutered? Yes No   If No, Why?
Are all dogs and cats on heartworm preventative? Yes No   What brand?
Are their medical records/vaccinations current for:   Parvo Yes No Don't Know      
Bordatello Yes No Don't Know               Distemper Yes No Don't Know
      Lepto Yes No Don't Know               Rabies Yes No Don't Know

What other dogs and/or cats have you owned in the past 15 years, and what happened to them?

Veterinarian's Name         Phone:

Life with a Cocker Spaniel

Which Cocker Kid(s) caught your interest?

Why do you want a cocker spaniel?

Have you ever had a Cocker Spaniel before? Yes No
If Yes, What happened to it / them?
Is this Cocker Spaniel a gift for someone? Yes No
Is everyone in your household aware and agreeable to adopting a Cocker Spaniel? Yes No
Are you financially capable of taking care of an ill or injured pet? (This can cost hundreds of dollars) Yes No
Where will you keep your pet during the day?
      during the night?
What will you feed your Cocker Spaniel?
Where will you have your Cocker Spaniel groomed?
      How often?
How many hours a day will your pet be without human companionship?
What will you do with your pet if you move?
If you leave town, who will care for your pets?
Who will take care of your animal if something happens to you?
Is anyone in your household allergic to dogs? Yes No
      if yes, please elaborate:

Adoption Agreement - You must agree to these terms


Please read carefully: As part of the adoption process, our organization does follow-ups on our placements. We will call and if we deem necessary, do a home visit. You also understand that the adoption is not final for 30 days following placement. During that time, you are fostering our rescue. We reserve the right to void the adoption and pick up the dog.

People adopting cockers from Cocker Spaniel Rescue must understand that the organization has NO BACKGROUND INFORMATION on the animal’s previous environment, behavioral problems, including biting (if any) and medical history. We cannot guarantee the dog’s health although we attempt to alert the adopter to any known health issues. In most cases the age of the dog is estimated but your veterinarian may age it differently. Our veterinarians may not have identified every physical problem the dog has. Some diseases/conditions have long incubation periods and a negative test is not a guarantee the animal does not have a certain disease.

Introduction of a new animal into a home carries certain risks that must be assumed solely by the adopting party. Cocker Spaniel Rescue is not liable for damages that may result from such an introduction. We are an organization operating as a community service with the intent to do only good and no harm.

Your signature on this agreement is your promise to:

  1. Protect your dog from heartworms year around by using monthly heartworm preventative,
  2. Keep your dog inside except for potty breaks and exercise,
  3. Provide a good quality dog food and water on a daily basis,
  4. Provide medical attention as needed and annual immunizations,
  5. Have the dog groomed a minimum of 6 times a year,
  6. Return the dog to Cocker Spaniel Rescue of East Texas if you can no longer care for the dog, and
  7. Give unconditional love through sickness and health, and especially in old age.

When you adopt an animal from Cocker Spaniel Rescue, the dog will have a collar and ID tag. The tag is registered to this organization. You are strongly urged to have your own ID tag made immediately. If the dog is running loose, picked up by Animal Control or a Good Samaritan, and Cocker Spaniel Rescue is contacted, we reserve the right to refuse to return the dog to you. Your signature on the adoption application certifies that all the information is accurate and truthful. If we discover the information on the application is false or misleading, we reserve the right to confiscate the dog.

YOUR SIGNATURE(S) IS YOUR PROMISE TO PROVIDE THE MEDICAL, EMOTIONAL AND PHYSICAL NEEDS OF YOUR PET FOR THE REST OF ITS NATURAL LIFE. IF, AT ANY TIME YOU CAN NO LONGER KEEP YOUR COCKER, THE ANIMAL IS TO BE RETURNED TO COCKER RESCUE.


I have read the Adoption Agreement and agree to its terms Yes No



___________________________ _______        ___________________________ _______
Signature of Adopter Date Signature of Adopter Date
 

 

Approval: ___________________________ _______ Financial donation:$ ___________    Cash: ____   Check # _______
Signature of CSR Representative Date


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