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Humane Society of the Treasure Coast Off-Site Pet Adoption
Animal Info:
Shelter ID Number:
Animal Name:
New Name Change Request:
Pet's Location (Ask a store associate for location information):
Pet Supermarket - Stuart
Pet Supermarket - Morningside
Pet Supermarket - St Lucie West
Pet Supermarket - Sympatico Plaza
The Kitty Cup
The Bark Park
North Thrift
Central Thrift
Special Event
Adopter Info:
First Name:
Last Name:
Driver’s License #:
Driver’s License State:
Date of Birth:
Email Address:
Home Street Address:
City:
State:
Zip code:
Primary Phone #:
Emergency Contact for Microchip (This should be someone other than the adopter):
Emergency Contact First Name:
Emergency Contact Last Name:
Emergency Contact Phone #:
Questionnaire:
I currently:
Own
Rent
Live with Family
Are there other adults in the home?:
Yes
No
Do children live in or visit the home?:
No
Yes - Lives in Home
Yes - Visits Home
If yes, what ages are the children?:
My household is:
Mostly quiet
Sometimes noisy or sometimes quiet
Constantly active & noisy
What types of pets currently live in your home?:
Ages of current pets:
Do you have a current veterinarian?:
Yes
No
If yes, vet's name:
Contracts & Agreements
View Upper Respiratory Infection/Kennel Cough Policy
HERE
I certify that I have read and understand the UPPER RESPIRATORY INFECTION/KENNEL COUGH Policy of the Humane Society of the Treasure Coast:
View Declawing brochure
HERE
I certify that I have read and understand the DECLAWING Policy of the Humane Society of the Treasure Coast:
Adoption Contract
Adoption Agreement by and between the Humane Society of the Treasure Coast, Inc. (hereinafter referred to as HSTC) and the person described above.
I agree to provide adequate food, water, shelter humane protection and veterinarian care to the animal entrusted in my care:
I agree to return the animal to the former owner, if claimed within thirty days in case of a stray:
I agree that if the animal becomes ill, I will provide all medical care at my own expense:
I agree to not sell or dispose of animal. If said animal is rehomed, gifted, or no longer in my care I will notify HSTC and assure information on animal (including microchip) is updated and accurate:
I understand the animal must be spayed / neutered by the HSTC contracted veterinarian. If the pet is unable to be spayed / neutered at the time of adoption, I understand as part of this agreement, I must comply with Florida Law and have my pet spayed/neutered within 30 days of adoption, and hereby expressly agree to do so:
I understand that the HSTC reserves the right to repossess any animal, which I have adopted from HSTC, if I am deemed unfit to care and/or provide for the animal. Furthermore, if I violate the adoption agreement with the HSTC , I am liable for any and all attorney's fees and court costs incurred by the HSTC in enforcing this agreement, and I expressly agree to be so liable:
I understand that if my animal is under 4 months of age, at the time of adoption, he/she HAS NOT been vaccinated against RABIES. The fees associated with this vaccination will be my financial responsibility:
I understand that if said animal is returned to the shelter after 30 days from adoption, I am responsible for paying a surrender fee associated to HSTC:
The HSTC makes no claims or representations as to the behavior, age or temperament of animals offered for adoption. I hereby accept possession and title of the animal at my own risk. I hereby agree to release, indemnify, and hold harmless, the HSTC, its Officers, Directors and Employees, which I may have now or which may arise in the future for any damages to any person or property caused by said animal. The HSTC cannot guarantee the health of any animal after it leaves our shelter. Our staff has made every effort to see that the animal you are adopting is in good health. However, it is possible that an animal may harbor an illness in an incubation stage and may become ill after adoption. The HSTC is NOT responsible for any Veterinary bills incurred in the treatment of this or any other animal. I hereby acknowledge that I have specifically been advised of the risk of infection of the animal with conditions including Upper Respiratory Infection and Kennel Cough
I certify that I have read and understand the IMPORTANT NOTICE above:
Payment Type:
Credit Card
Cash
Would you like to make an adoption donation in addition to your adoption fee?:
No thank you
$5
$10
$20
$50
$100
Would you like to make a custom donation?:
Credit Card Information
First Name on CC:
Last Name on CC:
Credit Card #:
Expiration Date:
What We Do
What We Do
Pet Adoptions
Dolly’s Dream Adoption
Pets for Patriots
Thrift Stores
Services for Pet Owners
Public Spay & Neuter
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