Electronic Adoption Agreement Date MM slash DD slash YYYY Animal's Name: Animal's SexMaleFemaleWeightTag # Color Breed Age Foster Your Name (Adopter 1) First Last Adopter 1 PhoneAdopter 1 Email Your Name (Adopter 2) First Last Adopter 2 PhoneAdopter 2 Email Home Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Mailing Address (If Different) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country 1.* I agreeAs of the date written above, ADOPTER(S) specifically PROMISE TO • Treat this animal as a beloved member of the family, including providing a safe and loving home, a balanced diet, veterinary care, and professional training as necessary; • Keep an ID tag with current address and telephone number fastened to this animal’s collar; • Attach a leash to this animal’s harness or collar EVERY TIME this animal is out of doors and not in a safely enclosed area for at least the first year from the date above; • Allow this animal to play or walk off-leash ONLY in a safely enclosed area; • Enroll in animal behavior training class(es) as appropriate for this animal’s age and size; • Contact UTAH ANIMAL ADOPTION CENTER immediately if this animal becomes lost; and • Read the UTAH ANIMAL ADOPTION CENTER Adoption Handbook that is available on the website. 2.* I agreeADOPTER(S) specifically agree TO NEVER • Abuse or neglect this animal or allow it to be abused by others; • Allow this animal to procreate or reproduce; • Place this animal in a shelter, state or county or city animal control facility, or with another rescue organization; • Sell, re-sell or give this animal away;3.* I agreeIf, during the lifetime of this animal, ADOPTER(S) determine that adequate care or control of this animal can no longer be provided by ADOPTER(S), ADOPTER(S) agree to contact UTAH ANIMAL ADOPTION CENTER and describe the changed circumstances. UTAH ANIMAL ADOPTION CENTER reserves the right to, within thirty days after being notified of the changed circumstances, make any determination which in UTAH ANIMAL ADOPTION CENTER’S sole discretion, is in the best interests of this animal, including but not limited to rescinding the adoption and taking this animal back into its care and control.4.* I agreeADOPTER(S) understand and agree that if at any time UTAH ANIMAL ADOPTION CENTER becomes aware of neglect, abuse, or failure to provide for this animal’s care and control, UTAH ANIMAL ADOPTION CENTER reserves the right to immediately rescind ADOPTER(S)’ adoption of this animal and take this animal back into its care and control, without further notice.5.* I agreeADOPTER(S) understand that this animal is a rescued animal, and that no claims, representations, or warranties are made or implied by UTAH ANIMAL ADOPTION CENTER as to this animal’s age, breed, physical or mental characteristics, prior experiences, current or future health, behavior or temperament.6.* I agreeADOPTER(S) understand and agree that recommendations made by UTAH ANIMAL ADOPTION CENTER may, or may not be, helpful in securing the safety of people or other living things that come into this animal’s proximity; and that the safety of all living things who do so, is hereafter solely ADOPTER(S) ethical and legal responsibility. Specifically, whether or not this animal has been housed with men, women, children, cats, dogs, or any other living things in a foster care provider’s home, UTAH ANIMAL ADOPTION CENTER makes no warranties regarding this animal’s behavior with any living thing hereafter. ADOPTER(S) agree to use caution and allow sufficient time for success when introducing this animal to any living thing.7. Placeholder, let's talk about this one* I agreeADOPTER(S) understand that this animal is a special needs animal, with a current diagnosis of _____________________________________________________________ which may require short or long term care, and promise to supply the care this animal needs.8. Placeholder - let's discuss* I agreeADOPTER(S) understand that the donation of $___ made today to UTAH ANIMAL ADOPTION CENTER will become part of its general funds to pay the necessary fees and other expenses of animals that it rescues, is not a payment for this animal, may be tax deductible, and is non-refundable.9.* I agreeADOPTER(S) understand and agree that, as of the date of this agreement, UTAH ANIMAL ADOPTION CENTER has no further financial or legal liability as relates in any way to this animal, including but not limited to any damage to person(s) or property, or medical or other expenses.10.* I agreeADOPTER(S) have been allowed sufficient time to consider the terms of this AGREEMENT, and all parties enter into it in good faith and willingly.Blurb about relying on donations - Rocket Dog relies entirely on donations to save and rehome over 700 dogs a year. 57% of our budget is spent on medical care ranging from $200-$2000+ per animal. Give more. Save more. No dog left behind.Signature (Adopter 1) Signature (Adopter 2)