RELEASE
In consideration of the donation of the
sum of $1.00, the receipt of which is hereby acknowledged, the undersigned
Adopter(s) do hereby forever release, discharge and covenant to hold harmless
the New England Old English Sheepdog Rescue, Inc, hereinafter known as NEOESR,
Inc, and any other person, firm or corporation charged or chargeable with
responsibility or liability, their heirs, administrators, executors, successors
and assigns, from any and all claims, damages, costs, expenses, loss of
services, actions and causes of action belonging to the said Adopter(s) arising
out of any act or occurrence for the present time, and particularly on account
of the adoption of:
Dog's
name:____________________________________________________.
To procure the payment of the said sum,
the Adopter(s) hereby declare(s): that no representations about the nature of
said dog, nor any representations regarding the nature and extent of legal
liability or financial responsibility have induced the Adopter(s) to make this
Release and Indemnity Agreement; that in determining the amount of said sum,
there has been taken into consideration age, health, veterinarian services and
care of the said dog, up to the present time.
The undersigned hereby further agrees to abide by the "Terms of
Adoption" listed below:
1. Neutering. The said dog must be neutered or spayed by _________________. Said dog may not be used for breeding purposes.
2. Return. If, for any reason, the adoption is not satisfactory to the adopting party, or if the Adopter(s) fail(s) to comply with all the terms and conditions of the Agreement, or if any misrepresentations have been made by the Adopter(s) during the entire life span of the adopted dog, the dog must be returned to the NEOESR, Inc. If return takes place prior to 30 days from adoption and the dog is in as good or better mental and physical condition as on the date of adoption, there will be a conditional, prorated refund of the adoption donation subject to the Rescue's decision. There will be no refunds after 30 days.
3. Transfer of Ownership. The "Rescue" dog may not be transferred to any other person, firm, corporation, or organization for any reason whatsoever.
4. Security. Said dog must not be maintained or tied outside as a yard dog, nor shall said dog be allowed off leash without supervision unless in a fenced in area. The primary and ONLY function of a "Rescue" dog is that of a house pet. We require, at all times, a fenced area or walks on leash.
5.
Health Program. The Rescue dog will be placed on an inoculation
program and daily or monthly heartworm preventative established by the
Adopter's veterinarian, in order to guarantee the health of the dog. ANNUAL
RABIES VACCINE
6. Grooming. Rescue dog will have coat maintained in a reasonable manner as described during interview. Attention to tangled areas and external parasites is important for the health of said Rescue dog.
7. Reservation of Rights. The NEOESR, Inc. reserves the right to follow through on this adoption in order to protect the welfare of the "Rescue" dog. If the terms and conditions of this agreement are not upheld by the Adopter(s), and/or if any misrepresentations have been made to the NEOESR, Inc. by the said Adopter(s), the NEOESR, Inc. reserves the right to terminate this Agreement, and the adopting party must return the "Rescue" dog to the NEOESR, Inc.
8. Attorney Fees and Costs. Should it become necessary for the NEOESR, Inc. to take legal action to recover an adopted dog or otherwise enforce the provisions of the Agreement, the Undersigned Adopter(s) agree(s) to pay all court costs and reasonable attorney's fees.
9.
Contact.
All questions about the “Rescue” should be
directed to the NEOESR office. Under no
circumstances should the adopter get in touch with the “Rescue’s” former owner.
The
undersigned understands that the parties hereby released admit no liability of
any sort by reason of the said adoption and that said payment is made to
terminate further controversy respecting any and all claims for damages that
said Adopter(s) have heretofore asserted or might personally or through
personal representative hereafter assert because of said adoption.
SIGNED
Adopting Person: Name (print):
_______________________________
Donation Amount: __________
Signature: ______________________________________
Address:
_________________________________________________________________________________
Telephone: _______________________ E-mail:
____________________________________
Witness: Signed In the presence of (print
name):___________________________________
Witness Signature: ___________________________________________
Please send this
form to: NEOESR Inc., 49 Stonehedge Road, Lincoln, MA 01773