Basenji Rescue and Transport, Inc.
ADOPTION CONTRACT
For official use only. Name of Dog: _________________________________
Age:_______________
BRAT Tag Number (if available):_______________________
Basenji Purebred: _____ Basenji Mix: _____
Other: _____
Color: ( ) Red/White ( ) Black/White ( )
Tri-Color ( ) Brindle ( ) Other ________
Sex: ( ) Male ( ) Female
Basenji Rescue and Transport, Inc., a Texas
non-profit corporation (BRAT), has established this Contract to detail the
specific requirements to which the Adopter must comply as a condition of
the Adoption/Transfer of the pet Basenji and/or the Basenji Mix (referred
to herein as the "Dog") whose name and description appear above.
ADOPTION
I agree to comply with the following
requirements as part of the adoption process of the above named Dog, and
fully understand that failure to do so will result in this Dog being
returned to BRAT. I also understand and agree that BRAT or its agent may
visit my home upon reasonable notice or make inquiry about said Dog at any
time and, if BRAT is not satisfied that the conditions of this Contract
have been complied with, I agree to return the Dog to BRAT without
reimbursement or recourse. Moreover, should BRAT need to file legal action
to reclaim the Dog, I agree to pay all reasonable legal fees and expenses
incurred by BRAT.
Upon execution of this Contract by both the Adopter and BRAT (the "Execution Date"), I
will become the legal owner of the Dog and am responsible for the Dog and
its care. Copies of any health/veterinary records available will be
supplied to me either at the time the Dog is transferred or on the
Execution Date.
Furthermore, I fully
understand and agree that:
1. BRAT makes no
guarantees or warranties, express or implied, regarding the Dog,
including but not limited to the Dog's health, training or behavior. The
parties acknowledge and agree that every dog has the potential to bite or
damage property. While BRAT evaluates each Dog's temperament, and has
disclosed to Adopter any temperament issues of which BRAT had prior
knowledge, it cannot guarantee that the Dog placed with Adopter will never
bite or damage property. Upon execution of this contract by Adopter and
BRAT, Adopter agrees to fully indemnify and hold harmless BRAT (including
its directors, officers, attorneys coordinators and stationmasters) for
any and all losses, liabilities, claims, damage or harm done by the Dog to
Adopter or any other person or animal. Further, Adopter agrees to take
full responsibility for any liability resulting from the Dog's behavior.
2. BRAT has advised me of
all known defects (health or otherwise) as well as any behavior or
training problems regarding this Dog, either in the Internet posts, web
listings for the Dog, private email, or as follows:___________________________________________
3. BRAT assumes no
responsibility, whether financial or otherwise, for any medical conditions
(known or unknown at the time of placement), treatments, procedures or
examinations of the Dog which occur or are discovered after the earlier
of the date the Dog is physically transferred to the Adopter or the
Execution Date. In exceptional circumstances, the BRAT Board of Directors
may, upon request, and in its sole discretion, choose to provide financial
assistance to Adopter after the date the Dog is physically transferred to
the Adopter and/or the Execution Date.
A. I agree to supply and bring a collar,
lead and pet carrier (crate) or harness when picking up the Dog. BRAT will
supply an identification tag for the Dog. I agree that the Dog shall wear
this tag at all times in addition to any personal pet tag I may purchase.
If the Dog is micro-chipped, the microchip information will be supplied to
Adopter, if available.B. I agree to reimburse
BRAT, at the time of adoption, an adoption fee of $_______ for coverage
of any and all direct and indirect expenses incurred and paid by BRAT
for the medical care, placement and well being of the Dog. Payment may
be made either by check payable to BRAT, Inc., or with a credit card by
sending the fee to our PayPal
account at: bratinc@gmail.com
C. If the prior owner/foster has not
already done so, I agree to take the Dog to a veterinarian within two (2)
weeks after adoption for a complete examination. I agree to purchase any
dog license required by law. I also agree to comply with any applicable
Federal, state or local animal ordinances.D. This Dog has _____ or has not _____ been
spayed or neutered. The parties acknowledge that BRAT cannot transfer
ownership of the Dog if spay/neuter has not been completed unless specific
authorization from the BRAT board of directors has been attached hereto
and the following box has been initialed by a BRAT representative _____.
Sterilization of the animal is required
under Chapter 828, Texas Health and Safety Code; a violation of the
Chapter is a criminal offense punishable as a Class C misdemeanor.
E. I agree to provide for and treat the Dog
in a humane and responsible manner with adequate food, water, care and
veterinary services, and agree that the Dog shall not be used for medical
or any other experimental purpose. For purposes of this Contract, humane
and responsible care includes, but is not limited to, the following:
1. Providing veterinary examinations
annually;2. Keeping immunizations current as
required by local law and in consultation with the recommendations of my
veterinarian; 3. Administering heartworm preventative
according to a schedule provided by my veterinarian and strip testing my
Dog every month for sugar in the urine;4. Providing adequate
exercise for the Dog and/or providing a facility defined as a securely
fenced area or kennel run. I specifically agree that the Dog will not be
kept on a chain and will have a heated space for sleeping. I further agree
that when the Dog is outside, s/he will be leashed at all times, unless in
a secured fenced-in area. I acknowledge that I will not use
an electronic fence—or any like it that uses shock, noise,
vibration, or irritant—as a means of containment;
5. Maintaining the Dog as a house pet, not
an outdoor pet; and6. Agreeing that the Dog will not be used for breeding purposes.
F. I agree to indemnify and hold BRAT
harmless from any responsibility related to behavior deviations, illness
or property damage occurring after adoption of the Dog.
G. I agree to respond to a BRAT
Representative when such Representative contacts me for an update on the
Dog for the life of the Dog.
H. I agree to contact BRAT (either by email
or by calling BRAT, toll free, at 877-488-7328) to update any change of
address, telephone number or email address that I might have for the life
of the Dog.
I. I agree not to sell, trade or give away
the Dog. If, at any time, I can no longer care for or keep the Dog, I
agree to return said animal to BRAT for no consideration.
J. I agree not to euthanize the Dog without
first acquiring permission from BRAT (by calling BRAT, toll free, at
877-488-7328). BRAT has first right (but not the obligation) to reclaim
the Dog and may do so within seven (7) days of notice. I agree to care for
the Dog and pay any and all expenses (including kennel fees if necessary)
during this time.
EXCEPTION: I may euthanize the Dog without
first acquiring permission from BRAT if the Dog is suffering from a
terminal health ailment or if the Dog is obviously suffering from physical
pain (example: hit by a car), as attested to by a veterinarian. I agree
that I will inform BRAT within one (1) week of euthanization.
K. I agree to notify the BRAT Representative named in this contract and/or BRAT within forty-eight hours
of the time I learn that the Dog has been lost, stolen or killed.
L. Both parties of this Contract agree that
if any provision(s) of this Contract is determined to be unenforceable,
the parties agree that the remainder of the Contract is severable and
shall not be affected by any unenforceable provision(s).
I certify that all representations
contained herein are true and correct and that I have read, understand and
agree to the stipulations contained in this Contract:
Signed on this ______ day of
_____________________, 20____.
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ADOPTER: ___________________________________
Signature
___________________________________
Printed Name
___________________________________
Address
___________________________________
City, State, Country, Zip Code
___________________________________
Home Area Code and Phone
___________________________________
Work Area Code and Phone
___________________________________
Email Address
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BRAT REPRESENTATIVE:
___________________________________
Signature
___________________________________
Printed Name
___________________________________
Home Area Code and Phone
___________________________________
Work Area Code and Phone
___________________________________
Email Address
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After this Contract has been executed, both
the Adopter and the BRAT Representative should keep a copy for their
records and return the original, along with payment, to:
B. Ann Hageman
321 W View St
Lombard IL 60148-1515 E-mail:
b.ann321@comcast.net . Web Site:
http://www.basenjirescue.org
Revised May 20 2010 |