By checking "I Agree,” I understand I am considered a potential adopter. The potential adopter and any and all individuals present with the potential adopter recognizes and understands the inherent risk associated with the interaction and care of animals, including but not limited to the possibility of any injury to person and/or property, including your existing pets, which potential adopters may suffer as a result of the unpredictable nature and/or provocation of animal(s). In consideration of this assumption of risk, the potential adopter and any and all individuals present with the potential adopter hereby knowingly and willingly waives any and all claims, damages or causes of action which potential adopter may have or incur against Wright-Way Rescue, its officers, directors, agents, affiliates, employees and/or volunteers as a result of the interaction and potential adoption of an animal from Wright-Way Rescue.
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I’m interested in adopting:
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Adopter's Full Name:
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First Name
Last Name
Date of Birth:
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Please note: Wright-Way Rescue only adopts to applicants who are at least 21 years old. Applicants aged 18-20 will be considered with additional references. If you are under 21, an adoption counselor will be in touch for more information.
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If you are under 21 years old, please provide names and phone numbers of at least TWO references below.
Adopter's Address:
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
Daytime Phone Number:
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Email Address
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How did you hear about Wright-Way Rescue?
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If under 21, Guardian Name:
Guardian phone number (if applicable):
With whom do you live?
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Children’s Ages, if any:
Number and type of current pets in household, if any:
Do any members of the household suffer from pet allergies? If so, what kind?
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Home Ownership Status:
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Own
Rent or Rent to Own
Landlord’s name and number, if any:
Residence type:
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Single Family Home
Condo
Mobile Home
Apartment
Dorm
Other
Security deposit amount, if any (If you’re required to pay a security deposit for your pets):
Employer’s name:
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Employer's Phone Number:
Position:
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Length of employment:
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On your longest day away from home, how many hours will your dog be alone for?
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4 or less
4-8
8-12
12-23
24+
Please describe any special accommodations you will make for an adopted puppy or dog while you are at work/away from home. IE dog walker, friend to help during housebreaking stages, doggie daycare, etc. If you do not plan to or cannot make special accommodations, please note that here.
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Will the animal be living with you?
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Yes
No
If you answered no to the question above, please provide the name and contact information for the person the animal will be living with.
Who will have primary care of this pet?
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Myself
Other
If you answered "Other" to the question above, please provide more information and the contact for this pet's caretaker.
Have you adopted from us before? If so, please include approximate adoption date.
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Have you ever surrendered an animal to us before? If so, please explain why.
Reason for wanting a pet?
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Where will this pet be kept during the day?
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House
Garage
Fenced Yard
Outside
Tied up in Yard
Crate or Cage
Confined in Room
Other
Where will this pet be kept at night?
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House
Garage
Fenced Yard
Outside
Tied up in Yard
Crate or Cage
Confined in Room
Other
Who will care for the pet when you leave on vacation?
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Do you intend to have this pet spayed/neutered? If not, please explain why.
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How do you plan to exercise this pet?
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How many pets have you had in the past? If any, what happened to them?
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Have you ever house-trained a dog?
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Yes
No
Have you ever obedience-trained a dog?
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Yes
No
Do you plan to crate train your adopted dog?
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Yes
No
Would you like information about Wright-Way Rescue’s dog training program?
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Yes
No
Veterinarian Phone Number:
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Please list all preventatives you’re currently using or plan to use (heartworm, flea, tick), if any.
Are your current pets spayed or neutered?
Yes, they are and proof can be located with my veterinary reference
No, they are not
Unsure
I don’t have any other pets
Do you understand that Wright-Way Rescue makes educated guesses as to the breed and age of dogs that are offered for adoption but cannot guarantee any rescued pets actual genetic make-up or exact birth date?
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Yes
No
Are you aware of the current related laws that pertain to owning a pet where you reside?
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Yes
No
Often times, pets coming from a shelter environment will require continued medical care to treat and/or prevent intestinal parasites. Are you prepared to provide this needed care for an adopted pet?
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Yes
No
Puppies under the age of four months require a series of three to four vaccines before being considered fully immunized. Adult pets will require yearly booster vaccines. Are you prepared to provide this needed care for an adopted puppy?
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Yes
No
Dogs who are in shelters have a higher risk of exposure to illness due to the amount of animals they are potentially exposed to. Wright-Way Rescue makes every effort possible to ensure the health and well being of it’s adoptable pets. Once in a while, despite best efforts, a pet will become ill post adoption. Pet insurance is provided that typically helps to cover the cost of minor health issues. Adopters are responsible for the deductible and signing up for this insurance offer after adoption. If a life threatening illness occurs within one week of adoption Wright-Way Rescue will take back the pet and treat him or her at our partner veterinarian. As a non-profit organization, any bills you incur at your private veterinary clinic will not be repaid. Do you understand the health and treatment policies of Wright-Way Rescue?
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Yes
No
Please note that despite meeting these requirements, Wright-Way Rescue reserves the right to deny any adoption it feels is not in the best interest of the pet or adoptive family. Do you understand the right of refusal policies of Wright-Way Rescue?
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Yes
No
I understand that an approved application does not secure a reservation for any specific animal. Once you have received your adoption approval, you may contact Wright-Way Rescue by email at rescue@wright-wayrescue.org to formally request a reservation.
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Adopter’s Name:
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Adopter's Name Acting as Signature:
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Date:
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