Adoption Application

**The application is a part of the adoption contract if selected for adoption.

**Kanoa Rescue Foundation reserves the rights to deny/refuse any adoption application for any reason without specification to the applicant.

** All information is required, if not provided your application may not be considered.

Please provide a valid Driver's License or other form of Picture ID.

First name

Last name

Email

Phone

Birthday

Month

Day

Year

Address (MUST INCLUDE CITY AND ZIP CODE):

Animal Species You're Interested In:

Name of Animal You're Applying For:

Why are you interested in adopting this animal? (Please Check All Reasons that Apply):

Please explain why you selected your reasons for wanting to adopt this animal and what other reasons you may have for wanting to adopt this animal:

Do you own your home or do you rent/live with someone else?

Own My Home

Rent/Live With Someone Else

Landlord Name:

Landlord Phone Number

Landlord Email Address

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

Yes

No

Unsure

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:

What types of pets have you had?

What type of experience do you have with animals? Please explain your 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.

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?

Yes

No

Unsure

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?

Yes

No

Unsure

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?

Yes

No

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

Please explain why you would need to give up your pet:

Why would you like to adopt this particular animal?

Is there anything else you would like us to know?

Reference #1 First and Last Name:

Reference #1 Phone

Reference #1 Email

Reference #2 First and Last Name

Reference #2 Phone

Reference #2 Email

Reference #3 First and Last Name

Reference #3 Phone

Reference #3 Email

Read and Initial Each Statement Below. Do you understand that this adoption application is a part of your adoption agreement if you are selected?

I Understand and Agree

I Do Not Understand and Do not Agree

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

2. I understand and agree to provide this animal with routine medical care as well as emergency medical care if needed. Please initial below:

3. I understand and agree that a home visit may be required before an adoption is approved. Please initial below:

4. I understand and agree that a follow up visit may be required two weeks after the animal has been adopted (this may be in the form of a home visit, phone call, or text message). Please Initial Below:

5. I understand and agree that Kanoa Recue Foundation has the right to perform home visits for the lifetime of this animal. Please initial below:

6. I understand and agree that I am responsible for the medical care of this animal once adopted. Please Initial Below:

7. I understand and agree that if Kanoa Rescue Foundation assists with any medical after adoption that I will take them to a veterinarian approved by them. Please initial below:

8. I understand and agree that Kanoa Rescue Foundation has tested the animal for temperament and behaviors issues but cannot guarantee future behaviors or temperament of the animal. Please initial below:

9. I understand and agree that Kanoa Rescue Foundation is not liable for any behavior issues or injuries that the animal may do once adopted. Please initial below:

10. I understand and agree that this animal is not to be used for breeding or consumption by people o rother animals (all cats/dogs are spayed/neutered but some other species may not qualify for these surgeries). Please initial below:

11. I understand and agree that I will not have an animal's body mutilated (i.e. declawing, branding, ear cropping, etc,). Please initial below:

12. I understand and agree that this animal will primarily be an indoor pet (this may exclude livestock/farm life). Please initial below:

13. I understand and agree that I will provide proper shelter/husbandry, diet, exercise, and time for this animal. Please initial below:

14. I understand and agree that Kanoa Rescue Foundation reserves the right to reclaim this animal at any time (this could be due to frequent escaping, neglect, abuse, etc. at the discretion of the foundation). Please initial below:

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

16. I acknowledge that I have read and understand each statement thoroughly. Please initial below:

17. I understand and agree that this is a legally binding contract and agree to all terms and conditions. Please initial below:

18. I understand and agree that I cannot rehome, sale, adopt out, give away, etc. this animal and that I must return them to Kanoa Rescue Foundation or receive approval to rehome the animal. Please initial below:

19. I understand and agree that I cannot release this animal or take them to a municipal shelter or another rescue. Please initial below:

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

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