*This Adoption Agreement is a legal document.  Please read it carefully because it contains legal information which is intended for the protection of all parties, especially for the protection of the adopted dog.

Current owner’s name:  Billie Sue Bruce (Save Just One)

Address: Rt. 3 Box 1502   Jonesville, Va. 24263

Phone: 276-346-4257

Adopted animal description:  _____________________________________________________________________________________________
_____________________________________________________________________________________________

I, _______________________, hereafter referred to as the adopter, agree to a home visit  at a future date, either by
Billie Sue Bruce of Save Just One or another rescue worker/representative acting in her behalf.

I hereby agree that the above described animal is being adopted by me solely as a pet for myself and/or immediate family and further agree that I will not sell, give away or otherwise dispose of said animal to any person(s), dealer, retailer, auction, institute or any other entity for any reason. If for any reason I become unable or unwilling to keep this pet, I agree to first contact the above described current owner and give them the option to reclaim said pet at no charge. I agree to care for the above described pet in a humane and responsible manner and to provide it with clean and adequate shelter, food, water and veterinary care, and further agree that the said pet shall reside in my home and shall not be allowed to roam freely, and that this pet shall wear a collar or harness with identification tags at all times.

I hereby understand and agree that the current owner makes no representations or warranties, expressed or implied, about the above mentioned animal’s temperament and is hereby absolved from any liability for future damages or injuries caused by said animal. I also understand and agree that the current owner further gives no guarantees, expressed or implied, of the suitability of the animal to the adopter and/or his family.  

Further, (if applicable) I agree to have this intact dog spayed/neutered by ______________and obtain a sterilization certificate from the veterinarian.   This form and a self-addressed envelope will be provided.  (Note:  In most cases the dog will have already been neutered/spayed.  Exceptions would be very young puppies or a case where because of health reasons any surgeries should be delayed.)

I hereby agree that the adoption fee of _______ helps to cover expenses incurred in caring for the animal and is not refundable.

Adopter’s Name:   ______________________________________

I certify that all statements made by me on this adoption agreement are true and correct. I agree that the current owner has the right to confiscate the above described animal in the event that any statements made by me are found to be false, or in the event I fail to furnish the sterilization certificate (if applicable) or deny a requested home visit.