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Adoption Application (all information is required)

**Must be able to provide a valid ID**

Name of Animal of Interest:
What are your reasons for wanting an animal? (Please check all that apply)


About the Home

Name of landlord/home owner:

If you are renting do you have permission to have the animal you are interested in?

How are you planning on keeping this animal on your property?

Please list ALL the people, both adults and children (please specify age of children) who live in your residence or visit often:

Pet Experience

What types of pets have you had?

What type of experience do you have with animals?

Please list any other information you would like us to know about your pet/animal experience:

Please list ALL pets you have had in the past five year (please include species of animal, spayed/neutered [if not why], and if they are still with you [if not please include why]):

Do you have any special needs animals? If so please explain their condition.

Things to think about

Are you able to make a longer term commitment to care for your pet for his/her entire life span, which could be as long as 15 years or more?

Pets are an investment of your time and money. Can you afford to provide medical care, grooming, proper diet, shelter, and exercise for your new pet?

What Veterinarian do you use and/or plan to use for your pets?

If you do not have a veterinarian would you like a referral?

Which of the following reasons may force you to give up your pet? (Please select all that apply)

Please provide 3 references (Name, Phone Number, and Email)




Please read and initial each statement below:

I understand and agree to pay the adoption fee Kanoa Rescue Foundation has set in place to help continue saving lives of other animals.

I understand and agree to provide this animal with routine medical care as well as emergency medical care if needed.

I understand and agree that a home visit may be required before an adoption is approved.

I understand and agree that a follow up visit is required two weeks after the animal has been adopted (this may be in the form of a home visit, phone call, or text message). I understand and agree that Kanoa Rescue Foundation has the right to perform home visits for the lifetime of this animal.

I understand and agree that Kanoa Rescue Foundation is responsible for routine medical care for two weeks after the adoption is completed. I understand and agree that the animal can ONLY be seen by an approved Kanoa Rescue Foundation veterinarian to qualify for coverage (hospice, special needs, and medical adoptions may qualify for lifetime coverage, additional forms are required).

I understand and agree that if for any reason I decide the animal is no longer a fit for my household, the animal must return to Kanoa Rescue Foundation and that I forfeit the adoption fee and do not qualify for any type of reimbursement (medical, food, crate, etc). I understand and agree that I do not have the authority to rehome this animal even if it is to family members or friends.

I understand and agree that Kanoa Rescue Foundation has tested the animal for temperament and behavior issues cannot guarantee future behavioral issues or the temperament of the animal.

I understand and agree that this animal is not to be used for breeding or consumption by people or other animals (all dogs/cats are spayed/neutered but some exotics and farm life may not qualifty for these surgeries).

I understand and agree that I will not have an animal's body mutilized (i.e. declawing, branding, ear cropping, etc.)

I understand and agree that this animal will primarily be an indoor pet (this may exclude livestock/farm life). I understand and agree that I will provide proper shelter/husbandry, diet, exercise, and time for this animal.

I understand and agree that Kanoa Rescue Foundation reserves the right to reclaim this animal at any time.

I acknowledge that everything I have written/signed in this document is TRUE and none of the information that has been provided is FALSE.

I acknowledge that I have read and understand each statement thoroughly.

I understand that this is a legally binding contract and agree to all its terms and conditions.

Electronically sign and date that you acknowledge all information you provided to be true and that you agree to this contract.

Kanoa Rescue Foundation reserves the rights to deny/refuse any adoption applicant for any reason without specification to the applicant. This questionnaire/application is a part of your contract for adoption.

Thanks for submitting!

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