SAVED ME, INC
858 North 3rd St
Philadelphia, PA 19123
(215)240-1240
[email protected]
Pet:
Animal Name___________________ Number________________
Type_______________Species___________Breed______________
Sex__________Age______________Birthday_______________
Primary Color_________Secondary Color__________Pattern___________
Coat Length___________Markings_____________ Microchip #____________________
Adopter:
Name____________________________
Address___________________________
City______________State____Zip______
I.D._____________________Type________Issuer___________
Date Of Birth________________Issued______________Expiration___________
The use of the term "adoption" or "foster" in this Agreement and elsewhere by Saved Me is not intended to guarantee nor imply that the terms, rights, responsibilities or other
circumstances of this transaction are similar to the "adoption" or "foster care" of a child. Under Pennsylvania law, all types of pets are considered personal property.
However, this transaction is NOT a sale, gift, nor a lease of the pet.
TERMS AND CONDITIONS:
1. The welfare of this dog/cat is the sole responsibility of the Adopter. The Adopter agrees to give the dog/cat adequate
care which includes quality food, fresh water, sanitation and grooming, clean and secure indoor housing, exercise and
to ensure overall safety or the animal.
2. The Adopter agrees to safely and humanely contain and control the dog/cat and to abide by all applicable local
municipal leash and animal control laws and state animal cruelty laws. Adopter will keep this dog/cat as a house pet
and family member only. This dog/cat is not permitted to live in an outdoor space, outbuilding or garage. This dog/cat
must be protected from severe cold and heat. When outside, Adopter will always keep a dog on a tie-out (at least 15
feet long), hooked on a harness, or in a fenced yard, always with fresh water readily available. It will NEVER be
chained up. It will NEVER be permitted to run loose outside an unfenced yard. Crating can be used when Adopter is
not home, but for no more than 8 hours a day. The Adopter will not transport the dog/cat in an open vehicle or in any
way endanger this animal.
3. After adoption, this dogs/cat’s health is the Adopter’s full responsibility. Adopter agrees to take the dog/cat to a
veterinarian within three weeks of adoption to verify its health status and to purchase heartworm preventative and
flea/tick preventative medication. The dog/cat will receive proper care by a licensed veterinarian throughout the
dog/cat’s entire life, including ANNUAL EXAMS, ALL RABIES AND DHLPP SHOTS, as well as all other
preventative and required treatments in accordance with veterinary recommendations for the LIFE OF THE
DOG/CAT. Adopter will arrange for immediate veterinary care in the event of illness or injury.
a. I have been made aware of the following condition(s) and agree to provide the care recommended and to
monitor this pet's condition. If the conditions worsen or do not improve I agree to seek treatment at my own
veterinarian and agree to accept the financial responsibility of any treatment requirements:
Condition: ___________________________________________________________ (please initial)_________
Condition: ___________________________________________________________ (please initial) _________
Condition: ___________________________________________________________ (please initial)_________
b. I understand that illnesses and medical conditions may not be apparent at the time of adoption and that
although the pet I am adopting has been examined by a licensed veterinarian, it is not possible to detect all
injuries, illnesses or contagious, hereditary or congenital conditions until the condition progresses or becomes
symptomatic. I agree that these unforeseen illnesses, injuries, and conditions will be my responsibility to correct
and I will not hold Saved Me, it’s partners or assignees responsible for correcting or treating any of these.
(please initial)_______
c. I have been told about the 30 day gift of insurance, it’s terms and conditions and agree to activate this
insurance in one of three ways: by signing on to www.24PetWatch.com, calling 1-877-291-1524 or clicking the
link in the email from 24Petwatch.com.
Remember: You MUST confirm your Gift within 7 days of adoption.
Confirmation provides you with your policy Document of Insurance, Product Coverage Chart, and Terms and
Conditions of coverage. Read these documents carefully.
After you have confirmed your Gift of Insurance, call 1-877-291-1524 to extend your policy by an additional 15
days.
If you have not received an email from 24PetWatch within 48 hours please make sure you confirm your gift by
either calling or confirming on www.24PetWatch.com
Once you have confirmed your Gift, coverage will begin on the second midnight following adoption. For
example: If you adopted anytime on Saturday, coverage begins on Monday at 12:01AM.
Don’t get caught with expensive veterinary bills, confirm today! Make sure you confirm your policy
immediately. You must confirm your Gift within 7 days of adoption, otherwise the Gift of Insurance will be
voided and you will not be able to submit any veterinary claims. (please initial)________
d. I have been told about the possibility of contagious and potentially deadly diseases, especially Distemper,
Adenovirus, Parainfluenza, Hepatitis, Canine Parvovirus and Kennel Cough for puppies and dogs
and rhinotracheitis, calici, and panleukopenia, Feline Leukemia and Feline Immunodeficiency Virus for
cats. I understand that a negative test result for any of these illnesses does not mean that the pet can not become
infected in the future and that these and other illnesses not mentioned can be contagious to my current pets and
that there are contagious diseases that can be transmitted from animals to humans. I therefore agree to monitor
my pet for symptoms of these illnesses, read the attachment to the post adoption emails and keep the new pet(s)
separated from my pets until my veterinarian tells me it is safe to let them mingle. I will also limit the pet(s)
access to areas of my home to minimize exposure to contagions. I understand that my pet may need to be dewormed again and continue to be treated with a product to prevent fleas and other parasites. I also understand
that my pet has been tested for but not treated with a preventative for heartworm. The test may need to be
repeated by my veterinarian. (please initial)________
e. I agree to take my new pet to my veterinarian within ten days of adopting him or her. (please intial)________
f. I understand that the phrase “up to date” with regard to vaccines means that the adopted pet has been given
required and recommended vaccines appropriate to the age of the pet and within the last calendar year. It may
be necessary for me to obtain boosters or annual vaccines depending on the pet’s age and the date the last
vaccines were given. I will consult my veterinarian for instructions on appropriate vaccines for my pet. I will do
this at my expense. (please initial)________
g. I understand that my pet is micro-chipped and that Saved Me recommends that I register the pet in my
name. A page containing instructions for doing so is included in the post adoption email.(please initial)________
h. I agree to check my email for any post adoption communication from Saved Me. (please initial)________
4. If this dog/cat has not already been spay/neutered, Adopter agrees to do so within thirty (30) days and is required to
send a copy of the spay/neuter certificate to Saved Me and/or its appointed agent within ten (10) days of completion.
Adopter understands that this is a requirement, not an option. SAVED ME and/or an appointed agent will follow up
with Adopter if written proof of spaying/neutering this dog/cat is not received within thirty (30) days of adopting this
dog/cat.
[ ] This dog/cat is already altered and the above provision does not apply. [ ] This dog/cat needs to be altered.
5. Adopter understands that no one can predict how a dog/cat will react in a new situation. Therefore, Adopter will
exercise prudence and caution in introducing this dog/cat into the new situation until the dog/cat has become fully
adjusted to its new environment and Adopter has had an opportunity to become familiar with this dog’s/cat’s unique
personality. Adopter assumes full responsibility for the conduct of this dog/cat, and for any damage to person’s or
property. SAVED ME and/or its appointed agent(s) make no explicit or implicit guarantees in reference to the health
and/or temperament of the dog/cat. The dog/cat is adopted “as- is” and the Adopter assumes all responsibility for
treatment of any and all existing conditions or any other physical, medical or temperament changes that may occur in
the future. SAVED ME and/or its appointed agent(s) or representatives cannot guarantee the health of any animal and
shall not be held responsible for any medical expenses which may be incurred. No warranty has been made or implied
about the dog/cat regarding behavior or fitness for any particular purpose, including, without limitation, any warranties
regarding health, temperament or whether the animal is housebroken.
6. This dog/cat will not be used for rituals, racing, fighting, medical or experimental purposes, or for protection of a
person or property as a guard dog. It will be nothing other than a house pet, companion and family member.
7. The ownership and responsibility for this dog/cat belongs solely to Adopter. However, if Adopter can no longer keep
this dog/cat or provide it with adequate care, including food, shelter or veterinary care, Adopter will return the dog/cat
to SAVED ME and/or an appointed agent without requesting a fee or any other form or compensation. This dog/cat
shall NOT be sold, given to, or adopted to anyone else, nor shall there be any transfer of ownership to any firm,
corporation, or organization of other homeless animals, such as another rescue facility, animal shelter or humane
society. Adopter will inform SAVED ME and/or its appointed agent(s) if the dog/cat has any behavioral or medical
conditions, which make finding another home inadvisable. If Adopter has to return the dog/cat to SAVED MEand/or its
appointed agent(s), return transportation is Adopter’s responsibility. Exception: If within five days of adoption the
adopter decides that he or she is unable to keep the pet under any of the conditions required in this contract a refund
may be issued and a $50.00 processing fee will be withheld.
8. Adopter understands that SAVED ME and/or its appointed agent(s) may contact him/her for further verification of
this dog’s/cat’s welfare at any given time.Adopter will cooperate by providing whatever information is requested and
Adopter will permit SAVED ME and/or its appointed agent(s) to visit the home or contact the veterinarian, if so
requested. Adopter will ensure that the information associated with the dog/cat’s microchip implant is current within 30
days of the change, so that Adopter can be contacted for the life of the dog/cat. If the dog/cat becomes lost, Adopter
will notify SAVED ME and/or its appointed agent(s) immediately.
9. Adopter understands that in the event he/she does not follow the terms of this Agreement or Adopter neglects or
abuses the dog/cat, SAVED ME, an appointed agent or any other animal authority has the right to take possession of
the pet, The Adopter agrees to pay SAVED ME and/or its appointed agent any and all expenses, including court costs
and reasonable attorney’s fees, in enforcing the terms and provision of this contract.
SAVED ME and/or its appointed agent(s) have provided the best information they can about the dog/cat, and Adopter
accepts responsibility for the dog/cat based on the information available and provided at the time of this Agreement.
Adopter does not hold SAVED ME and/or its appointed agent(s) or representatives responsible for errors in the
information provided about this dog/cat. The Release Statement below releases SAVED ME and/or its appointed
agent(s) or representatives from any and all liabilities with respect to this dog’s/cat’s behavior, actions, health,
performance or temperament. Adopter therefore forfeits any right to sue. Adopter understands that in the event he/she
gives false information or does not follow the terms of this contract, SAVED ME and/or an appointed agent may
reclaim this dog/cat and start legal proceedings against Adopter at Adopter’s expense, and may assess damages
and/or legal fees against the Adopter.
RELEASE STATEMENT:
I/We, the above named adopter(s) of the dog/cat identified in this Agreement, agree, understand and promises to
forever release, discharge, indemnify and hold harmless Saved Me, a 501(c)3 non-profit organization, or any of its
agents or representatives, board members, or any other person associated with this rescue, their heirs, administrators,
executors, successors and assigns from any and all claims, damages, costs, expenses, loss of services, actions and
causes of action arising out of bodily injuries, mental anguish or property damage or any other occurrence from the
present time on, caused by the adoption of this dog/cat. This includes any and all loss, damage, fees and expenses
(including legal or medical fees) by reason of liability imposed by law upon Saved Me or any of its agents or
representatives, heirs, administrators, executors, successors and assigns because of bodily injuries or death to any
person(s), or animal, including the adoptive owners, or any damage to property arising out of or in consequence of the
placement of this dog/cat, howsoever such injuries, death or damage to property may be caused, whether or not the
same may have been caused by, or may be alleged to have been caused by, negligence of the aforementioned parties or
any of their agents or representatives, or any other person connected with Saved Me. Adopter(s), the undersigned,
assumes sole responsibility for all manner of actions and causes of actions, suits, debts, accounts, bonds, covenants,
contracts, agreements, judgments, claims and demands whatsoever arising out of possession and/or the placement of
this animal. adopter also understands that this organization will not be responsible for any and all costs or expenses
associated with this animal from this day forth and that all such costs and/or expenses will be the adopter’s sole
responsibility. In addition, adopter hereby agrees that Saved Me, its agents or representatives, board members or any
other person associated with this rescue, their heirs and assigns, successors and executors, will not and cannot be held
responsible for the conduct, behavior, health or disposition of this animal. Adopter shall assume all responsibility for
damages, suits, debts and actions that arise from ownership of this animal. Adopter(s) realizes that adopter(s) hereby
give up any right to take any legal action whatsoever against Saved Me,, it's agent or representatives, board members,
heirs, administrators, executors, successors and assigns. Saved Me, and any other agents or representatives, board
members, executors, successors, agents and assigns, make neither warranty nor guarantee, expressed or implied, as to
the physical, medical, mental or behavioral condition of this animal, its background or its suitability or compatibility.
Adopter(s) therefore hereby releases Saved Me, and all of its heirs, administrators, executors, successors and assigns,
board members, and any other agents or representatives from any and all responsibility with regard to this
adoption, which adopter(s) undertake voluntarily and with full knowledge of the above release and its implications.
I authorize Saved Me to share my contact information with The Pet Mechanic for the purpose of receiving reminders
regarding the veterinary care of my adopted pet and notice of special offers. (please initial)________
I authorize Saved Me to share my contact information with it’s adoption Partners and sponsors for the purpose of
sending post adoption notices and special offers regarding my adopted pet. (please intitial)________
I authorize Saved Me to share my contact information with it’s agents such as volunteers and rescue partners for the
purpose of providing post adoption surveys, counseling and advice. (please initial)________
I authorize Saved !e to use my likeness to advertise and market adoptable pets and the actions required by it’s mission
and to promote itself in any media. (please initial)________
I certify that I have read and understand the terms of this Pet Adoption Agreement and Release Statement by signing
below on this_______ day of_________________________, _____________ date month year
________________________________________
Primary Adopter’s Signature
________________________________________
Secondary Adopter’s Signature
________________________________________
Primary Adopters Printed Name
________________________________________
Secondary Adopter’s Printed Name
________________________________________
________________________________________
Saved Me's Representative Signature
Witness Signature
________________________________________
________________________________________
Saved Me’s Representative Printed Name
Witness’ Printed Name