Cayman Islands Humane Society
P.O. Box 1167, Grand Cayman, KY1-1102, Cayman Islands
Phone: (345) 949-1461
Pet Adoption Application
Name: ______________________________________________________P.O. Box: ______________________
Street Address:_______________________________________________________________________________
Home Phone: _______________ Work Phone: __________________ Cell Phone:________________________
E-mail Address: _____________________________________________________________________________
Specified Pet Desired (including name if known): Cat ____________________ Dog _______________________
Are you over 18 years of age? Yes ______ No ______
Is anyone in your household allergic to dogs or cats? Yes _________________ No _______________
Are you a local resident? _____________ If not, please explain ________________________________
If you leave the island, will you take your pet with you? Yes ________ No _______ Maybe ________
Do you: Own: ___ Rent: ___ Landlord’s name & contact number: ______________________________________
Name of your vet
Please call them and give them permission to give us a vet reference
How many members are in your household? ________ Number and ages of children _______
Where will your pet be kept during the day? ______________Where will your pet sleep at night? _______________
Do you have a fenced in yard?_________ Pen for dog? _________ Type of shelter of outdoors _________________
Have you ever brought an animal to us? ______ Explain ________________________________________
Have you ever adopted from us? Yes ______ No ______ If yes, how long ago? __________
Please list your pet’s name(s), breed(s) and age(s) (current and in the last 4 years)
Name
Age
Breed
Where are they now?
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Do all of your current pets receive monthly Heartworm Prevention & yearly vaccines? _______
Do you agree that if for any reason you must give up this pet, it will be returned to CIHS? _______
Do you agree to follow up on all vaccinations (boosters and yearly vaccines)? _______
Do you agree to provide your pet with Heartworm Prevention on a monthly basis? _______
Are you willing to comply with follow-up calls/visits by the Cayman Islands Humane Society? _______
The adoption fee includes the first set of vaccines and spaying/neutering. Follow-up vaccines are not covered by the Cayman
Islands Humane Society. We do our very best to place only healthy animals for adoption, but animals with unknown
backgrounds can become sick. If this occurs, you have the option of returning the animal to the shelter, or having it treated at
your own expense by your veterinarian. If you choose to return the animal for this or any reason, please understand that NO
REFUND will be given. If you reserve the animal and then change your mind about the adoption, NO REFUND will be given.
I certify that all information I have given is true, and I understand that false information may result in nullifying this
adoption.
Signed: ___________________________________________ Date: _________________________________
Animal Name: ________________ Animal #: __________ Amount Paid: ______________
CIHS Agent: _________________
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Cayman Islands Humane Society
P.O. Box 1167GT, Grand Cayman, BWI
Ph# (345) 949-1461
Adoption Agreement
Please give careful consideration to adopting a companion animal. Animals are not toys or short-term commitments.
Make sure your lifestyle allows the time, patience and expense this animal will need over the next ten or more years.
1.
Animals are placed to live in a private residence only. The animal must not be lent, rented or sold as a guard dog or used
for: dog fighting, vivisection, food or in commerce of any kind. The animal must be kept as a domestic pet at all times.
2.
The adopter will feed and house the dog or cat in a suitable environment to the Society’s satisfaction. Cats should
remain indoors for their safety. In the case of a dog, the adopter will keep it as an indoor house pet or in a reasonably
large fenced area with adequate shelter from outdoor weather conditions. In the case of a dog, the adopter will exercise
the animal regularly. No animal may be allowed to roam off the owner’s property.
3.
Cats must not be declawed and animals cannot be altered cosmetic or human convenience purposes (i.e. ear cropping,
tail docking, etc.)
4.
The adopter must provide the animal with necessary veterinary care upon sickness, disease or injury. In addition, animals
must be taken to the vet once a year for routine vaccinations, etc., and, in the case of dogs, maintained on preventative
heartworm medication (the Society recommends that cats are also placed on heartworm medication).
5.
The adopter assumes full financial responsibility for the animal.
6.
The animal must be maintained humanely and in accordance with all laws and ordinances in force in the jurisdiction in
which the animal resides.
7.
The animal should wear proper identification at all times, and dogs must be licensed with the Department of Agriculture.
We strongly recommend having your pet micro-chipped.
8.
If lost or stolen, the Cayman Islands Humane Society must be notified within 24 hours.
9.
The animal must not be given away, sold or exchanged without the prior permission Cayman Islands Humane Society.
If an animal is returned to the shelter or reclaimed to the Cayman Islands Humane Society officer, there is no refund of
the adoption fee or any money spent on that said animal.
10.
The Cayman Islands Humane Society reserves the right to investigate, unannounced, the living conditions of any animal
adopted from it and has the right to reclaim and re-posses any such animal at any time if it is being kept in violation of
the Adoption Agreement. The Adoption Agreement, for the avoidance of doubt, includes these Adoption Rules and
Conditions.
I, (adopter’s name) ______________________________, have read the ten (10) Adoption Rules stated above. I understand the
Rules and hereby agree to fully comply with them. I further understand that the Rules from an integral part of this Adoption
Agreement and are legally binding and enforceable by the Cayman Islands Humane Society against me. I agree to surrender to an
agent of the Cayman Islands Humane Society any animal adopted from the same should the Cayman Islands Humane Society find
that the animal is being kept in violation of the Rules. The Cayman Islands Humane Society agrees to accept the animal back at any
time if for any reason I no longer wish to, or cannot, keep the animal.
Signed by the Adopter: _____________________________________
(Adopter’s Signature)
____________________________
(Date)
Signed for on behalf of the Cayman Islands Humane Society: ___________________________________________________
(CIHS Agent)
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