BASSET RESCUE of OLD DOMINION, Inc.
3445 Seminole Trail, Box 248
Charlottesville, VA 22911
866-710-9476 (toll free)
brood@brood-va.org

PET ADOPTION AGREEMENT

1. I/WE, ________________________________________, DO HEREBY ACKNOWLEDGE RECEIPT OF:

Dog's Name:________________ Dog ID Number:______ Sex: Male Female

Age/DOB:_______ Color/Markings:___________ Approx. Wgt ________

Spayed/Neutered: Yes No Breed/Mix:__________________

I/WE agree to take care of __________________ (Hereinafter "the dog" ) in accordance with this agreement.

2. I/WE agree that in accordance with this adoption agreement, that under no circumstance will we sell, trade, give away, or otherwise dispose of the dog in any way, but will, if necessary, return the dog to a designated agent of BASSET RESCUE OF OLD DOMINION, Inc. hereafter BROOD, Inc.

3. I/WE also agree to provide and pay for all required vaccinations for the dog and all necessary veterinary treatment, should the dog become sick or injured or in any other way require veterinary attention. I/WE agree to have the dog vaccinated annually for distemper and parvo as well as have rabies updated for a 1-3 year period. I/WE also agree to have the dog checked annually for heartworm and other parasites and maintained on a preventative medication which will minimize risk. I/WE will attach an identification tag to the dog's collar which will be worn at all times.

4. I/WE also agree that the dog that is to be adopted shall be a companion animal and a house pet, and will not be used for breeding purpose. The dog shall be spayed/neutered within 30 days of adoption. Written confirmation of the spaying/neutering by a licensed veterinarian must be provided to BROOD, Inc. within 45 days of adoption (if applicable). Further, the dog will not be used for hunting, guard purposes, or in any way for the sole purpose of spectator entertainment (e.g., pit fighting, racing).

5. I/We agree the the dog will be housed within my/our house and will not be left to sleep or eat outdoors. I/We agree to keep the dog inside the house when no one is at home. I/WE agree that the the dog will not be chained, staked or tied outside.

6. If the dog becomes lost or stolen, I/WE will notify BROOD, Inc. immediately.

7. Failure to comply with the terms of this agreement will result in the return of the dog to BROOD, Inc. custody. Furthermore, I/WE understand that BROOD, Inc., or its designee may examine and make inquiry about the dog at any time and if not satisfied with the conditions may reclaim the dog immediately upon giving oral or written notice without monetary compensation.

8. I/We agree to be wholly responsible for expenses and liabilities arising in relation to the dog, howsoever derived, upon completion of adoption. While BROOD and its agents will endeavor to assess the nature and health of the dog, and will inform the adopter of any problems it discovers in relation to the dogs behavior or health prior to adoption, neither BROOD nor its agents will be held in anyway responsible for any injury, accident, illness, activity, well being, damage to property or third parties, or loss or damage that may occur subsequent to adoption of the dog, nor during any trial adoption period or foster arrangement.

9. I/WE therefore agree to release BROOD, Inc. and its agents from, and indemnify BROOD, Inc., and its agents against all liability, loss, expense, or loss of, or damage to property, whether incurred or suffered by me/us or any other person, firm, or corporation who, or which, may seek to hold me/us responsible, if such incident arises out of, or is caused by, the acts, physical respect to, any dog involved in this transaction. In addition, I/WE agree that BROOD, Inc. and its agents has made no warranties, covenants, or representations, express or implied, in respect to any of the foregoing matters that a person would normally take into account or rely upon, before acquiring a dog, whether such matter is concealed or visible at the time of the transaction..

10. I/WE agree that this contract constitutes final notice of the requirements stated herein and no further notice is required to institute legal action for violation of the terms of this contract.

11. PROVISIONS/CONDITIONS/REQUIREMENTS:
The first 14 days of the adoption period will be consider a "trial" period. During this period, the adopter can return the dog to BROOD for any reason and the adoption fee will be returned and the contract void. Should the dog be returned for any reason after the trial period, the adoption fee is forfeited.

Within the first 14 days following the signing of this contract, the dog is required to be seen by a certified veterinarian. Any health condition discovered that was not previously disclosed to the adopter will be cause for return of the dog to BROOD for a full refund. BROOD will not be held responsible for any health condition found after the 14-day trial period.

During the 30-day period following the signing of this contract BROOD, Inc. or any of its agents retains the right to visit the premises wherein the dog is domiciled to inspect in person the conditions under which the dog is living and ensure any conditions and requirements set forth under this contract have been met and are being adhered to.

At any time during the 30-day period following the signing of this contract, either BROOD, Inc., any of its agents, or the party/parties bound by this contract have the right to render the contract null and void for cause. However, should the adopting party/parties wish to return the dog, the dog must be returned to BROOD, Inc. as indicated in paragraph 2 above.

I/WE HAVE READ AND UNDERSTAND THE ABOVE AND AGREE TO ABIDE BY ITS CONTENTS.

AS REQUIRED BY THE CODE OF VIRGINIA, CHAPTER 787 3.1-796.96:5 Subsection C, I/WE ALSO CERTIFY THAT I/WE HAVE NEVER BEEN CONVICTED OF ANIMAL CRUELTY, NEGLECT OR ABANDONMENT.

Name (Printed):___________________________________________

Signature:________________________________________________

Address: ________________________________________________

City:__________________ State:_________ Zip:__________

Telephone: Home (___) ________ Work (____) ______________

AGENT DESIGNATED BY BROOD, Inc:

Name (Printed):______________________________________

Signature:_________________________________ Date:______________

Previous Owner: BROOD, Inc.
Address 3445 Seminole Trail, Box 248
City: Charlottesville State: VA Zip: 22911
Telephone: Home ( ) Work (301 ) 770-7170

Medical/Inoculation Information:

Previous Vet:

Known feeding schedule/type of food and amount:

Known special habits/likes and dislikes, etc.:

Addendum:(effective 17 March, 2001):
ATTORNEYS FEES AND COSTS: I/We agree to be responsible for any and all legal fees incurred if a violation of this contract results in a lawsuit or any litigation. I/We understand that this contract is binding in Virginia, The District of Columbia, Maryland, West Virginia, Pennsylvania, and Delaware and that noncompliance with any of the terms of this agreement, including failure to pay or problems encountered in the collection of the adoption donation, may result in legal action and seizure of the dog. I/We have read and understand the information in this adoption contract and agree to abide by the terms set forth herein.

Initial (adopter)____________

(BROOD representative) ________

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