Pet Adoption Application Form

Adoption Application, Contract and Waiver

Perspective Pet Parent*

First NameLast Name

Name of Pet You Wish to Adopt*

Email Address*

Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Do you own any pets?*

Pet Name(s)

Pet Breed(s)

Pet's disposition and behavior towards other dogs?

Please provide your veterinarian's name and phone number:

Do you own or rent your home?*

OwnRent

Do you have a yard?*

YesNo

If "Yes" to the above, is it fenced? please describe

What is your landlord's pet policy?

If you rent, please provide your landlord's information here:

Have you ever surrendered a pet you own to any animal shelter?*

YesNo

Have you ever been convicted of an animal related crime, such as cruelty to animals, animal theft, or animal abandonment?*

YesNo

If you answered "Yes" please provide a detailed description:

By clicking the submit button, I agree to McCrory Animal Rescue adoption process.
By clicking the submit button, I understand there is no "cooling off" period, and that if I no longer want or can no longer care for my adopted pet, I agree to notify McCrory Animal Rescue and to allow McCrory Animal Rescue to make arrangents for my pet to be taken back into rescue.
By clicking the submit button, I agree not to hold McCrory Animal Rescue responsible for any losses, lawsuits, claims, injury, damages incurred by me or to any persons or property by my adopted pet, once adoption has been completed.
By clicking the submit button, I understand that McCrory Animal Rescue will disclose any of the pet's health or behavior issues known by the above named rescue group before adoption is completed.
By clicking the submit button, I verify all of the above information is true and accurate.

Signature of Potential Pet Parent*