New England Old
English Sheepdog Rescue, Inc.
49
Stonehedge Road, Lincoln, MA 01773 (781) 259-8173 www.neoesr.org
___________________________________________________________________________
Release
& Indemnity Agreement
THE UNDERSIGNED
ADOPTER(S) agree(s) to abide by all of the "Terms of Adoption" as
indicated below. The Adopter(s) must place Adopter(s) initials next to each and
every paragraph to indicate that the Adopter(s) read and understand(s) the
terms and conditions set forth, herein.
TERMS
OF ADOPTION
_____ 1. Release
and Indemnity Agreement. IN
CONSIDERATION of payment of the adoption fee to the New England Old English Sheepdog
Rescue, Inc. ("NEOESR, Inc.")
in the sum of _____________________ Dollars ($______ ) (determined by taking
into consideration the age of the dog at the time of adoption), and the
adoption of the dog named below, the undersigned Adopter(s) hereby forever
release(s), discharge(s), covenant(s) to hold harmless and to fully indemnify
New England Old English Sheepdog Rescue, Inc. and their heirs, administrators, executors,
successors and assigns or any other person, firm, corporation or agent acting
on NEOESR, Inc.'s behalf, from all claims, damages, costs, expenses, loss of
services, actions and causes of action belonging to the said Adopter(s) or to
any and all third parties, arising from or occurring out of any act or omission
involving the adoption of the dog named below and any injury, harm or damage to
person or property which this dog may cause from the time of adoption, until
the end of time.
Dog's Name:
_______________________________________________
_____ 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 any or all terms and conditions set forth in this 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 NEOESR, Inc. immediately. If the Adopter(s) return(s) the
dog within 30 days after the date of adoption, the adoption fee may be refunded
on a pro-rata basis subject to the Board of Directors' ultimate discretion.
There will be no refund granted after 30 days.
_____ 3. Transfer of Ownership. The
Adopter(s) promise(s) not to transfer or relinquish ownership of this dog to
any other person, firm or corporation for any reason whatsoever. Furthermore,
the Adopter(s) promise(s) not to surrender this dog to any animal shelter or
other animal welfare organization and Adopter(s) promise(s) not to abandon this
dog. NEOESR, Inc. has made the Adopter(s) aware that NEOESR, Inc. will accept
return of this dog at any time and for any reason. The Adopter(s) must call NEOESR,
Inc. to make arrangements for the dog to be returned. Furthermore, the
Adopter(s) pledge(s) to make prearrangements to notify NEOESR, Inc. and to have
this dog returned immediately to NEOESR, Inc. in the event the Adopter(s)
die(s) or become(s) physically unable to properly care for this dog. The
Adopter(s) understand(s) and agree(s) that in the event of the Adopter(s) death
or physical impairment (to the degree to which providing adequate and
appropriate care for this dog is hindered or prevented) NEOESR, Inc. will regain all rights in ownership, custody,
control and possession of this dog immediately.
_____ 4. Neutering.
In the event that this dog is not neutered/spayed, the dog must be neutered or
spayed by _______________________________. This dog may not be used
for breeding purposes.
_____ 5. Care.
The Adopter(s) understand(s) that this dog must be kept as a companion animal
and must live inside the home of the Adopter(s). The Adopter(s) or anyone
acting on the Adopter(s) behalf must not keep this dog chained or tethered in
an unsupervised manner at any time. The Adopter(s) agree(s) not to let the dog
roam free in an unfenced, uncontained area without the dog being under direct
supervision and voice control. The Adopter(s) agree(s) to provide all necessary
treatment and veterinary care, including annual check-ups, and the Adopter(s)
promise(s) to place the dog on an inoculation and heartworm preventative
program as established by the dog's veterinarian, in order to guarantee the
dog's continued health and well-being. The Adopter(s) agree(s) to abide by all
applicable Federal, State and local laws and regulations pertaining to the
keeping and the ownership of this dog. As such, the Adopter(s) must ensure that
this dog is up-to-date on rabies vaccinations at all times, and that the dog is
licensed and registered in the town or city in which the dog resides. This 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 the dog. The Adopter assumes all financial responsibility and liability for
this dog, Including but not limited to: costs of food, costs of veterinary care
and any other future costs, both foreseen and unforeseen. The Adopter(s)
agree(s) that this dog must wear an identification tag tag with all relevant
contact information of the Adopter(s), Including but not limited to: the dog's
name, residential address, and phone number(s) to allow contact in the event
that the dog goes missing. The Adopter(s) promise(s) to notify NEOESR, Inc. promptly
if the dog goes missing or when changing address or phone numbers.
_____ 6. Reservation
of Rights. New England Old English Sheepdog Rescue, Inc. reserves the
right to conduct on-going monitoring of this adoption, and the Adopter(s) agree(s)
to allow NEOESR, Inc. to visit the dog's residence periodically to check on the
dog's mental and physical health and well-being and to ensure compliance with
all of the terms and conditions set forth in this Agreement. If the terms and
conditions of this Agreement are not upheld by the Adopter(s), or if any
misrepresentations have been made to NEOESR, Inc. by the Adopter(s), NEOESR, Inc.
reserves the right to terminate this Agreement at any time, and compel the
Adopter(s) to return the dog to NEOESR, Inc. Furthermore, NEOESR, Inc. retains
the right to reclaim this dog when warranted or appropriate, as determined by
the Board of Directors, due to the dog being neglected, abused, or provided
with inadequate care, or due to any breach of this Agreement. The Adopter
agrees to relinquish custody, control and full ownership of this dog to NEOESR,
Inc. immediately, upon request, without legal writ or order if the Board of
Directors determines that the situation warrants reclamation to secure the
dog's health and well-being. These rights are enforceable in both law and in
equity.
_____ 7. Liquidated Damages. Adopter(s)
agree(s) to pay the NEOESR, Inc. the sum of $500.00 as liquidated damages in
the event that the terms of this contract are breached. Such damages are agreed
to for the purpose of establishing the value of the dog and a fraction of the
expenditures by NEOESR, Inc. to care for the dog. The Adopter(s) understand(s)
that NEOESR, Inc. may seek the return of the dog by judicial process or any
other legal means.
_____ 8. Attorney Fees and Costs. Should
it become necessary for NEOESR, Inc. to bring a legal action against the
Adopter(s) in the state of adoption to recover the adopted dog or otherwise
enforce the provisions of this Agreement, the undersigned Adopter(s) agree(s)
to pay any and all associated court costs and fees, reasonable attorney's fees
and all other costs associated with or related to NEOESR, Inc.'s efforts to
reclaim the dog.
NEOESR, Inc., AND
ITS REPRESENTATIVES MAKE NO GUARANTEE, WHATSOEVER, AS TO THIS DOG'S MEDICAL
HEALTH OR TEMPERAMENT, AND ACCEPT NO RESPONSIBILITY FOR ANY DAMAGE OR INJURY
THIS DOG MAY CAUSE TO PERSON OR PROPERTY, FROM THE TIME OF THIS ADOPTION, UNTIL
THE END OF TIME.
We / I,
________________________ , ________________________ , the Adopter(s) affirm
that we / I adopt this dog as a companion animal and we / I agree to abide by
the all of the specific terms and conditions set forth in this Agreement. We /1
have read and assert that we / I understand each and every clause contained in
this Agreement. We / I affirm that we / I have never been charged with animal
cruelty, and we / I declare that we / I do not operate as an animal dealer or
broker.
In the execution of
this Release and Indemnity Agreement, the Adopter(s) hereby declare(s): that no
representations, guarantees or warranties about the nature, behavior or
temperament of this dog, or any representations regarding the nature and extent
of legal liability or financial responsibility have induced the Adopter(s) to enter
into this agreement.
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.
__________________________________ ______________________________
NEOESR, Inc. Representative Signature Date
__________________________________ __________________________________
Adopter
Name (print)
Adopter Name (print)
__________________________________ __________________________________
Adopter
Signature Adopter Signature
______________________________________________________________________________
Adopter address
(town, state)
__________________________________ __________________________________
Adopter Phone(s) Adopter Email
Updated
August, 2010