2156 Pillsbury #155 ∙ Chico, Ca. 95926 ∙ (530) 895-8888
First Name*
Last Name*
Address*
City*
State/Province*
Zip/Postal Code* -
Email*
Home Phone*
Work Phone x
Cell Phone
Alt Email
Which pet are you interested in adopting?* Choose an animal: ADDIE AGNUS AIMEE ALMOND AMOUR Angel Foodcake Apricot (Squeakers) ARGENT ARNAUD ASHER AUBERGINE AUGUSTUS Aurora AVERY Banana (Faye) BEAU BEETLE JUICE Bellatrix BENJAMIN BERT Big Dawn BILLION BILLY BLUE V Boysenberry BRITTANY BROWNIE BITE BRUNO Buddy 67103 BUGS BUNNY CAMILA Cannoli Cantaloupe Carrot Cake Charlie CHEECH Cheesecake CHERRY CHESTNUT CHICO CHIQUITA CHOCOLATE CHIP Clara COLBY COLORADO CORBIN Croissant Curly Daisey S DARCY Denver DIME DIPPIN DOTS DOLLAR Donna Barkin Doodle Bear DORA DOTTIE DRAKO DUDE DUDLEY DUMPLING DURANT DUSTY DUTCH DWIGHT Eclair ELEANOR ELSAA EMERY ESMEE EXPRESS Felipe Finch FREDRICK Funfetti Cake GABE GALLETTE GAZPACHO GINN GISELE GLAD GOOBER GRACIE Grape (River) HANNAH HARDY HARLEYQUINN HEFTY HOOK HUBERT IGOR ISHMEAL JACKFRUIT JAMES JAYCE JEANETTE JIMMY POO JOURNEY KAYLEE Keroppi KIWI GUAVA KODY KOOKIE Lapis Lemon Cake Lenore LEONARDO LICORICE LITTLE GIRL LOLA BUNNY LOUIS K LOVEY Macaron MAGGIE Match me MAURICE MAXAMILLIO maxamillion MAYBELLE Mender MICHELANGELO Milly MISSY Moe MOLLY V MONICA MOOSE MUFFIN MULAN MURPHY NATASHA FATALE NESSIE NICKEL Nonno NYLAH OONA PACO TACO Padme Amidala Hops PALMER Pandapple PELICAN PELO PETUNIA PIG PICCOLO PIPER PIPSQUEAK POLARIS PONSONBY BRITT PORKY PIG QUINCY RED VELVET RENEE RICO ROMEO ROSE ELIZABETH ROUX RUBBLE RUBERT SANDERS SELENA SEQUOIA SERAPHINA SKULL Slightly SNEAKERS SNIDELY SOLO SOPHIA SOPHIE STAN STORMY Strawberry Cake STRIPES SULLY Sweetguy SWEETHEART Takota TAZZ TEDDIE Theana THOMPSON Thumpelina Tigaroo Timon TITUS TOAST Tootles Twister WAFFLES Walker WAYNE WEENIE WILLY WRANGLE Yankee YODA
What is your preferred method of contact? Choose one: Call Text
Are you at least 21 years old?* Choose one: Yes No
Are you currently a student?* Choose one: Full-Time Part-Time No
Current Employer:
Work Email:
Driver’s License Number & State:
Please enter TWO alternate contacts who we can contact should your pet be found and we are unable to get ahold of you. (Name and number) *
Alternate Contact 1 Phone*
Alternate Contact 1 Age*
Alternate Contact 1 Relationship to You*
Alternate Contact 2 Name
Alternate Contact 2 Phone Number
Alternate Contact 2 Age
Alternate Contact 2 Relationship to You
What type of home do you live in?* Choose one: Home Apartment Condo Mobile Home Other
Do you own or rent your home?* Choose one: Rent Own Live with Parents
If you rent, do you have your landlord’s permission to have/own a pet? Choose one: Yes No
Landlord's Name:
Landlord's Phone Number
Do you have a yard?* Choose one: Yes No
If yes, how big is the yard? Choose one: Small Medium Large (over 1/2 acre)
How will you keep the pet on your property?
If Other, describe:
Please list all members of your household with their relationship to you and their age. *
Has everyone in the household met the pet? * Choose one: Yes No
Is everyone in the household willing to make a lifetime commitment to the new pet? Are all decision-makers in the household on board with adopting a new family member? This means if you move. You take your pet. If you get married or divorced you keep your pet. If you have a baby, you keep your pet. If your pet gets sick you take it to the vet. If your pet shows unwanted behaviors, you enroll in training sessions and get him/her the help s/he needs. Our rescue animals have suffered enough heartbreak and are ready to be committed companions please be sure you are ready to be a committed owner. * Choose one: I Agree
If not, why?
If you have children in your household, have they been introduced to the pet? Choose one: Yes No
Have the children in your household, if any, previously been around this type of pet? Choose one: Yes No
If you have children in the home, do you plan on leaving them alone with the pet? Choose one: Yes No
Does anyone in the home have allergies?* Choose one: No Yes, to Dogs Yes, to Cats Yes, to Dogs & Cats
Current Pet 1 Species Choose one: Cat Dog Other
Current Pets: Please list - Species/Breed/Age/Sex/ is this pet spayed or neutered and is this an indoor or an outdoor pet?
Current Pet 1 Age
Current Pet 1 Sex Choose one: Male Female
Is Current Pet 1 fixed? Choose one: Yes No
Is Current Pet 1 an Indoor or Outdoor Pet? Choose one: Indoor Only Outdoor Only Both Indoor and Outdoor
Current Pet 2 Species Choose one: Cat Dog Other
Current Pet 2 Breed
Current Pet 2 Age
Current Pet 2 Sex Choose one: Male Female
Is Current Pet 2 fixed? Choose one: Yes No
Is Current Pet 2 an Indoor or Outdoor Pet? Choose one: Indoor Only Outdoor Only Both Indoor and Outdoor
Current Pet 3 Species Choose one: Cat Dog Other
Current Pet 3 Breed
Current Pet 3 Age
Current Pet 3 Sex Choose one: Male Female
Is Current Pet 3 fixed? Choose one: Yes No
Is Current Pet 3 an Indoor or Outdoor Pet? Choose one: Indoor Only Outdoor Only Both Indoor and Outdoor
Veterinarian's Name
Veterinarian’s Phone Number
Have you had pets in the past that you no longer own? Choose one: Yes No
Have you ever given up a pet?* Choose one: Yes No
If yes, why?
Have you ever euthanized pet?* Choose one: Yes No
If Yes, why?
Are there any other reasons you have not kept a pet in for its lifetime?
Have you experienced any behavioral problems with past companion animals? Choose one: Yes No
If yes, how did you address them?
Past Pet 1 Species Choose one: Cat Dog Other
How Many Years did you own Past Pet 1?
Past Pet 1 Sex Choose one: Male Female
Was Past Pet 1 fixed? Choose one: Yes No
Was Past Pet 1 kept Indoors or Outdoors? Choose one: Indoor Only Outdoor Only Both Indoor and Outdoor
Why do you no longer own Past Pet 1?
Past Pet 2 Species Choose one: Cat Dog Other
How Many Years did you own Past Pet 2?
Past Pet 2 Sex Choose one: Male Female
Was Past Pet 2 fixed? Choose one: Yes No
Was Past Pet 2 kept Indoors or Outdoors? Choose one: Indoor Only Outdoor Only Both Indoor and Outdoor
Why do you no longer own Past Pet 2?
Past Pet 3 Species Choose one: Cat Dog Other
How Many Years did you own Past Pet 3?
Past Pet 3 Sex Choose one: Male Female
Was Past Pet 3 fixed? Choose one: Yes No
Was Past Pet 3 kept Indoors or Outdoors? Choose one: Indoor Only Outdoor Only Both Indoor and Outdoor
Why do you no longer own Past Pet 3?
Have you ever adopted an animal from this rescue before?* Choose one: Yes No
If so, do you still have it? Choose one: Yes No
If you have adopted from us before but no longer have the pet please explain why
Do you own any Livestock?
What traits are you looking for in a pet?
How many hours each day will the pet be left alone?*
Where will the pet be kept when alone?*
Where will the pet sleep at night?*
Where will the pet be when you are at home?*
How do you plan to provide exercise for this pet?
Would you give up this pet for any of the following reasons? (Check all that apply)
Unless a licensed Veterinarian has advised Wags and Whiskers against spaying or neutering, all puppies must be spayed or neutered before they go to their forever home. Most adult dogs will also need to be spayed or neutered before going to their forever home. In certain circumstances, adult dogs that are not spayed or neutered may qualify for participation in our Foster to Adopt Program. Ownership of the pet remains with Wags and Whiskers until the pet has been fixed and adoption fees have been paid in full.* Choose one: I Agree
By submitting this application, the Applicant agrees to the following: 1. Wags and Whisker’s reserves the right to decline any application. 2. Be at least 21 years of age or have special consent from a Wags and Whisker’s representative. 3. Have a valid driver’s license or other government issued ID 4. Have the consent of your landlord to have the pet, if renting. 5. The adoption fee becomes non-refundable 14 (fourteen) days from the date of adoption, which, unless otherwise indicated, is the date of this Adoption Agreement. 6. To not keep the Pet on leased or rented property where a “No Pets” policy is in force 3. To provide adequate fresh food and water, clean and dry shelter, and daily exercise. The pet will not sleep outdoors or be left outside in bad weather. 4. To not tether the Pet in a manner causing it to suffer, or to confine the Pet in a cruel manner. 5. To obey all applicable laws governing control and custody of pets. 6. To provide a safe collar with the Applicant’s contact information. 7. To provide and finance all medical care and treatment needed by the Pet from the time of transfer. Normal health care is to include annual medical checkups, any vaccinations recommended by your veterinarian, and preventive flea and heartworm medications. 8. To keep the Pet only as an indoor, personal pet and companion, not as a gift and the Pet is never to be used for research purposes. 9. To hold Wags and Whiskers blameless for injury or death that pets in the adoptive house may incur. Care should be taken to acclimate the Pet to its new home and its inhabitants. 10. To pay all costs, including attorneys’ fees, if Wags and Whiskers must take action against the applicant or his or her representatives or agents to enforce any of the terms of this agreement.
I agree to the terms listed above.* Choose one: I Agree
To accept the liability for and to take steps to prevent any damaging pet behavior. Wags and Whisker’s does its best to provide an accurate description of the Pet before adoption, but Pet behaviors may change in a new home environment. This description does not guarantee that the Pet will always exhibit such behavior or that it will not develop new behaviors; it is simply meant to describe the Pet’s personality as exhibited while in Wags and Whiskers care. These behaviors were documented by a person who is neither a professional, nor certified behaviorist nor trainer. Wags and Whiskers MAKES NO WARRANTIES, EITHER EXPRESS OR IMPLIED, AS TO ANY MATTER WHATSOEVER, INCLUDING, WITHOUT LIMITATION, THE CONDITION OF THE PET, ITS MERCHANTABILITY, OR ITS FITNESS FOR ANY PARTICULAR PURPOSE. APPLICANT ACCEPTS THE PET ON AN “AS IS” BASIS.* Choose one: I Agree
For Check Payments: To pay a $25 service charge on any returned checks. If a check is returned by your bank, for any reason and the Applicant does not pay the total amount due, to include any service charges, within two weeks of written notification, it will be considered a breach of this Agreement and ownership of the Pet shall revert to the Wags and Whiskers.* Choose one: I Agree
Lost Pet: If you lose any pet adopted from Wags and Whiskers, notify Wags and Whiskers IMMEDIATELY at (530) 895-8888* Choose one: I Agree
REPOSSESION: I understand and agree that in the event I do not comply with, or follow the terms of this Agreement, including any addendums, ownership of the Pet shall revert to the Wags and Whiskers giving the Wags and Whiskers the right to take possession of the Pet. I further agree to give permission for an agent or representative of the Wags and Whiskers to remove the pet from my premises and entry shall not constitute a trespass upon the premises occupied.* Choose one: I Agree
If I can no longer keep the pet, I will return the pet to Wags and Whiskers, and not any other organization. I will NOT bring the pet to the pound. If I have found another home for the Pet, I agree not to transfer the Pet to this home until the prospective adopter has completed a formal adoption application and been approved by the Wags and Whiskers.* Choose one: I Agree
Adopting a dog is a responsibility. Please do not take it lightly. We offer several tools that make it possible for you to keep your pet. You have access to us 7 days a week and most hours of the day, if you need advice. PetSmart also offers a free dog training lesson.
1. All pets adopted from us must be returned to us if you are no longer able to keep them.
2. You must contacting us for advice or call a trainer, before you return a dog. If you return one, it must be done on a Saturday, before the adoption event and you must notify us at least 3 days in advance.
3. If you absolutely have to return a dog during any other time, there is a $100 fee that will be charged, if there is room to take the dog in.
4. Deposits are non-refundable. Puppies are completely non-refundable after pick-up. Adult dogs are refundable up until 14 days from their adoption date.
5. If we must hold onto your newly adopted pet for more than 2 days before you pick up, there will be a $10/day boarding fee. If you do not pick up your dog for more than 5 days without prior arrangement, we have the right to reclaim ownership of your pet.
6. Microchip registration will be transferred from us to you via the email address you provided on file. If you do not accept the microchip transfer from Found Animals when you get an e-mail from them, and the dog escapes, we have the right to reclaim ownership of your pet.
7. Please keep in mind that your new pet probably came from a kill shelter where there are many other dogs. We make every effort to make sure you are given a healthy pet. Unfortunately, they may have issues that we are not aware of at the time of adoption. This may be due to stress from change or previous exposure which may cause your new family member to start exhibiting signs of an illness. You may utilize your free wellness exam or contact us for our support during most hours of the day if this happens.
8. You have a free wellness exam vet visit voucher. Use it for a wellness check or if your new family member is ill. We will not reimburse you if you take the dog to another vet without prior authorization.
9. We provide the first years vaccinations for your newly adopted pet. All vaccines are done at our facility. For basic vaccinations, you may walk-in from 10-4 on weekdays, with the exception of our lunch break. Rabies and stitches removal require an appointment. Call (530) 895-8888 to schedule an appointment.
10. For dogs participating in our Foster-to-Adopt Program, we will provide basic vaccinations and spay/neuter but the current foster is responsible for other medical expenses that may occur with the dog.
11. When adopting a dog, make sure it's ok with your landlord, if you are renting.
MEDICAL DISCLOSURE WAIVER
While at Wags and Whisker’s Pet Rescue, your newly adopted dog may have been exposed to OR has recovered from an episode of Infectious Respiratory Disease (more commonly referred to as Kennel Cough or IRD).
Any further medical expenses sought out after adoption, including those that may result from an undetected underlying condition, will be at your own cost.
Wags and Whisker’s Pet rescue has informed me of known or observed medical issues with the animal I am adopting. I agree to care for this animal for the rest of its life in a manner that is necessary with these conditions.
I accept full responsibility for any treatment or warranted assistance and understand that Wags and Whiskers Pet Rescue will not be held financially responsible for the continued care of this animal.