Adoption Application

Pit Bull Crew

15275 Collier Blvd. #201-282, Naples, FL  34119

shannon@thepitbullcrew.com   / www.thePITbullCREW.com


When you adopt one of our dogs, you aren’t buying a pet; you are making a donation to our rescue work and by adopting, you are not only saving a life, you are saving TWO. We are a 501(c)(3) organization.


“Saving lives-one adoption at a time”

The Pit Bull Crew Dog Rescue    ADOPTION FEE $125 

Date of application: *
Name: *
Date of Birth: *
 /  / 
Phone: *
-
Alt. Phone:
-
Address: *
E-mail: *
How did you hear about The Pit Bull Crew Dog Rescue? *
Name of dog you wish to adopt: *
Why are you considering adopting a dog? *
Activity Level: *
Types of activity you want to do with dog: *
Where will the dog be when no one is home? *
Where will the dog be when someone is home? *
How many hours will the dog be home alone? *
Do you have a fenced in yard? *
How tall is the fence?
What type of fence?
Are all members of your household aware of your plans to adopt? *
If no, why?
Have you ever surrendered a pet to a shelter under any circumstances? *
If yes, please explain?
What will you do if your dog develops behavior problems that are unacceptable to you? *
What if any behaviors would you consider unacceptable and grounds for you not being able/willing to keep him/her and why? *
Explain your plan for introducing your new pet to your current pets: *
Name of current veterinarian: *
Address of veterinarian: *
Phone of current veterinarian: *
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May we contact vet? *

FAMILY INFORMATION

List all members living in household, including applicant:

1. *
2. *
3.
4.
5.
Do you have children visiting? *

Please list all pets currently in your household and/or owned in the past ten years:

Pet 1.
Pet 3.
Current on vaccinations?
Pet 2.
Pet 3.
Current on vaccinations?
Pet 3.
Pet 3.
Current on vaccinations?
Have you adopted from another shelter/rescue in the past? *
Do you live in a *
Do you *
Landlord's Name:
Landlord's Phone:
-
May we contact landlord?
Are there any breed restrictions where you live? *
Are there weight restrictions where you live? *
if yes, what is the max weight?
Would you agree to a home visit? *
Are you moving within the next 6 months? *
If so, please explain.
Is there any other information that you feel is important for us to know in consideration of you adopting one of our dogs?

Microchip Registration Information:

PLEASE LIST EXACTLY AS YOU WISH TO REGISTER CHIP

Name: *
Address: *
E-mail: *
Phone: *
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Alt. Phone: *
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Please Read and Sign Below:

In consideration of receiving the above-described dog (“Dog”) from The Pit Bull Crew Dog Rescue

Rescue (“PBCDR”), I hereby agree to the following terms and conditions: I agree to care for the Dog in a humane and responsible manner as a member of my family, and to assume full responsibility for the Dog’s well being for the rest of its life. I agree to provide sufficient shelter for the Dog, and to allow the Dog to reside indoors when I am at home, and to sleep inside my home at night (not limited to the garage) I agree to provide the Dog with a well-balanced diet, sufficient water and all necessary veterinary care, including vaccinations and annual physical examinations. I understand that the cost of any veterinary care following adoption is entirely my responsibility. I understand and agree that the Dog is a rescue dog and that dogs respond to situations differently and unpredictably. I understand and agree that PBCDR makes no representations or warranties, expressed or implied, about the Dogs health, behavior or temperament. I understand that my adoption fee is not refundable.

I agree to provide formal obedience training for my dog in the event I encounter any behavior problems with the dog, or in the event PBCDR requires such training as a condition of adoption. I agree that the Dog will wear an identification tag, which includes my name, current address and phone number at all times, and to obtain a license for the Dog in the city or county in which I live.

I agree to fully and completely release PBCDR, its officers, volunteers, agents, employees, contractors and representatives, from any liability of any kind whatsoever arising from any health or temperament issues the Dog may have or may develop, and/or from any and all claims relating to my adoption, ownership or possession of the Dog. I agree to indemnify and hold harmless PBCDR, its officers, volunteers, agents, employees, contractors and representatives from any and all losses, fines, claims or damages, including reasonable attorneys’ fees, arising out of or relating to my adoption, ownership or possession of the Dog, including any claims for injury or damage to persons or property caused by the Dog.

I certify that all of the information provided by me herein is true and correct. I certify that I am at least 18 years of age and fully understand the contractual obligations set forth above.

E-Signature: *
Date of Application: *
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