Welcome to LCAR

If renting, please enter your landlord's name and phone number. If you are living with family/parents please provide a contact for the home owner.

If you rent, have you received the approval of your landlord to have an animal?

Do you have a fenced in yard?

What type of fence?

If so, what is the approximate height of the fence?

Is the fence attached to the house?

Please provide your Veterinarian's Name and Phone Number (Current/Past Pets)

Name, type of animal, age and gender for current pets.

Are these pets Spayed/Neutered?

Are these pets up to date on their shots?

Please provide any additional details/comments about your existing pets.

Please describe all the pets you have previously owned in the last 10 years (MUST include Name, Type of Animal, Age, Gender, Year you got the animal, Year deceased, Cause of death or the last year you had the pet and where they are now).

Were these pets Spayed/Neutered?

Please provide any additional details/comments about your previous pets.

Please provide NON-FAMILY reference, including name, phone # and their relationship to you.

Please provide a NON-FAMILY reference, including name, phone # and their relationship to you.

Are you willing to properly train your dog?

Are you willing to take the time to housebreak a dog, and do you understand that changing a dog’s environment may cause the dog to have accidents?

If a behavioral problem arises, what steps will you take to work on it?

How often will you exercise the dog and for approximately how long?

Who will be responsible for feeding and taking the dog outside?

Who will take care of the dog in your absence?

How much time will the animal spend alone during the day

Where will the dog be kept when you are not home

Are you willing and able to accept financial responsibility for the expenses associated with caring for a dog? This includes preventative health care such as annual check-ups, vaccinations and emergency medical care in the event of illness or injury? This is in addition to regular care with the cost of food, supplies and equipment, toys, training and boarding? Please explain:

Are you aware of the adoption fee of $600 (All dogs) $300 - (For dogs deemed seniors by LCAR -generally 8 yrs and older) $200 - (For senior citizens over 65 yrs of age adopting senior dogs)

Would you object to an LCAR or SFF representative visiting your dog in their new home? ___Yes ___No

Yes

I, undersigned, agree to the following statements: • The information I provide will be verified before I am approved for adoption. • False statements or omissions of any of the above information will result in automatic refusal of adoption or confiscation of the animal. • LCAR has the right to refuse the adoption of any pet to any person. • The adoption fee is non-refundable. • I am willing and able to accept financial responsibility for the expenses associated with caring for a dog including preventative health care including annual check-up and vaccinations as well as emergency medical care in the event of illness or injury in addition to cost of regular care and feeding .(food, supplies and equipment, toys, training and boarding). • I understand that this animal will require training to reach its full potential. I fully understand the risks involved with interacting with animals and agree to assume all liability. I agree to hold Last Chance Animal Rescue and any and all of its affiliate programs harmless for any injury(s), loss or damages which I might sustain from interacting with the animals. This waiver includes myself, all of my family members and descendants forever from seeking any legal action whatsoever against Last Chance Animal Rescue or its successor organizations or any representatives thereof. Enter your name and today's date

Drivers License #, State of issue and Expiration date. You will be required to provide a copy of this license upon signing the adoption contract

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