| Full Name* |
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Full Address *
(include city, state, zip)
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| Email* |
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| Home Phone* |
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Work Phone |
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| Cell Phone |
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Other Phone |
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| I/we, the undersigned, agree to abide by the following terms in adopting a pet through PAWS, in consideration of the sum starting at $150 for a dog and $75 for a cat. |
| Other $ |
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| 1. Description of animal |
Animal's Name |
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Description (dog or cat) |
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Has animal been sterilized at time of adoption? |
Yes
No |
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* If no, please read and sign agreement on reverse side. * |
| 2. I/We agree to: |
a. provide proper food, shelter, constant supply of water and exercise
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b. accept this pet as a household companion and keep it as such
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c. not use a chain, rope, cable or kennel/run as the sole means of confinement
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d. get the animal prompt medical care if sick or injured
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e. not let it be used for any kind of lab/experimental work
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f. keep identification on the animal at all times
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g. notify PAWS at once if the animal dies or is lost or stolen
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h. notify PAWS at once if I/we have to give up the animal
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i. not to abandon or "dump" the animal
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j. obey my community's laws pertaining to animals
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k. hold PAWS harmless and defend them from any liability for any property or personal
damage caused by my/our pet, understanding that PAWS makes no guarantee about the age,
health, or temperament of this animal.
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l. having received a medical record card, stating what medical attention my pet has received
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m. NO REFUNDS of any kind. I/we have been offered the option to do a short term trial home
visit, where a refund is available.
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3. I/we will keep my/our pet's vaccinations and microchip information up-to-date.
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4. I/we give PAWS permission to investigate the animal's well-being and its new home at any time, including the right to come onto my/our property.
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5. Should PAWS find that this Contract has been violated after transfer of ownership, I/we grant PAWS the
exclusive option to purchase the animal for $1.00. If PAWS chooses to exercise this option, I/we will
surrender the animal peaceably and voluntarily to a PAWS representative and will give up any future claim
to the animal or against PAWS. No advance notice is required in PAWS' exercise of this option.
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| Adopter |
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Date |
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| PAWS Representative |
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Date |
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| Sterilization Agreement |
| I am adopting an animal that has not yet been sterilized. I agree to have this surgery performed and provide
written proof of completion by |
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(Date) |
| Written proof will be in the form of a receipt from a veterinary clinic and can be mailed to PAWS, PO Box
135, Jefferson, Iowa 50129. |
| If I have the surgery performed by a veterinary clinic other than the Fairview Veterinary Clinic, I will be
refunded --- upon providing written proof of completion. |
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(dollar amount) |
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1. Sterilization of the animal is required pursuant to Iowa Code section 162.20.
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2. Ownership of the dog or cat is conditional upon the satisfaction of the terms of the agreement.
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3. Failure to satisfy the terms of the agreement constitutes a breach of contract, requiring the return of the
dog or cat.
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4. A person failing to satisfy the sterilization provisions of the agreement is guilty of a simple misdemeanor.
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| PAWS Representative |
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Date |
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