MO-KAN BORDER COLLIE RESCUE
COMPANION ANIMAL ADOPTION AGREEMENT
www.mokanbcrescue.org

The animals in our care have been spayed/neutered, are up to date on vaccinations heartworm tested (if a dog older than 6 months) and on heartworm preventative. Mo-Kan Border Collie Rescue is made up of volunteers who give their time, abilities and homes to help place animals where they will receive loving care. The animals in rescue came into rescue for many reasons and with varied backgrounds. We will provide potential adopters as much information as we have on any animal adopted. Sometimes we will have information provided by the owner that released the animal. In the case of a stray we will only have information on their behavior and personality for the time the animal has been in our care. The following points are minimum requirements for adoption of a rescue animal from Mo-Kan Border Collie Rescue.

• The animal will receive the medical care and attention necessary to ensure his/her health and well being.
• The animal will not be abused in any manner and will be a companion living primarily indoors.No animal will be placed in a home where they will be outdoors at all times.
• The adopter will provide an adequately fenced yard for the animal to exercise in, unless it is determined that the adopter can provide the animal with adequate exercise under humane control. Chaining a dog is not considered adequate exercise or humane.
• The dog should have appropriate identification and contact information on at all times.

If at any time Mo-Kan Border Collie Rescue determines that the terms and conditions of this agreement have not been met or that the animal is not receiving proper, humane care, Mo-Kan Border Collie Rescue may choose to take custody of the animal. Under no circumstances should the animal be abandoned, taken to a shelter, sold, given away, or used for experimentation or guarding purposes. If the animal cannot be kept at any time or for any reason, Mo-Kan Border Collie Rescue is to be contacted at bcrescue@mokanbcrescue.org

All information listed below is confidential.

Animal’s Name: _____________________________________
Breed: _____________________ Color: ____________________
Sex: M / F        Spayed/Neutered: Y / N             Approximate Age: _________
Adopter’s Name: _____________________________________________________
Home Phone: ___________________ Work Phone: ___________________________
Email Address: _______________________________________________
Street Address: _____________________________________________________
City / State / Zip: _________________________________________________________

_______________________________________  _____________________
Adopter’s Signature                                                                             Date

_______________________________________  _____________________
MKBCR Representative’s Signature                                                     Date

MO-KAN BORDER COLLIE RESCUE
RECEIPT FOR ADOPTION
www.mokanbcrescue.org

In consideration of a donation of $ 200.00 , the receipt of which is acknowledged, ownership is transferred to the undersigned adopter(s) who releases, discharges and holds harmless Mo-Kan Border Collie Rescue from any charges or claims arising from the adoption of:
Name of Animal: ____________________
Description of Animal: _____________________________________________
On Date: _________________

The above-designated animal may be returned to Mo-Kan Border Collie Rescue within 14 days of the above date if the adopter is not satisfied with any aspect of the adoption. After this trial period, Mo-Kan Border Collie Rescue will still take the animal back, but no refund will be given as the fee will have already been used for the next rescued animal.

All expenses incurred by the adopter for the animal are the responsibility of the adopter. There will be no refund or reimbursement by Mo-Kan Border Collie Rescue for those expenses.

If the animal is lost by the potential adopter during the trial adoption period, the fee being held is retained by Mo-Kan Border Collie Rescue.

I have read and agree to comply with the terms of the above agreement.

_______________________________________  _____________________
Adopter 1 Signature                                                                            Date

_______________________________________  _____________________
Adopter 2 Signature                                                                            Date

MO-KAN BORDER COLLIE RESCUE
SPAY/NEUTER CONTRACT
www.mokanbcrescue.org

The below named dog was not altered before being adopted for the following reason: ________________________________.  Kansas & Missouri LAWs requires all shelter animals to be spayed/neutered.  You must agree to have the named dog spayed/neutered by the date stated below.  The spay/neuter deposit of  $150 will be refunded after proof of has been given.  Please write a separate check made out to MKBCR for this deposit.

No refund of the  $150 spay/ neuter deposit will be made if the animal is not spayed/ neutered and proof is not sent to MKBCR by date set below, NO EXCEPTIONS!!!  Furthermore, if the dog is not spayed/neutered by the date set above MKBCR has the right to reclaim said dog and you (the Adopter) will be responsible for all veterinary, transportation and attorney fees.

1.) I hereby agree to have ____________________ Spayed ___ Neutered ___  By _______
                                                Dog’s name                                                                  Date
2.) I understand that my deposit of  $150  will be refunded if the animal is altered by date listed above and proof has been sent to MKBCR.

3.) No later than 10 days from the above date I will send proof of spay/neuter to MKBCR in order to receive reimbursement.  Contact MKBCR at bcrescue@mokanbcrescue.org for the mailing address.

4.) MKBCR is not liable for death or injury to the animal during the spay/neuter procedure, nor by complications caused thereby.

Adopter’s Name (Print)____________________________
Phone__________________________________
Address________________________________
City_________________________________ State_____________ Zip__________

_______________________________________  _____________________
Adopter’s Signature                                                       Date

_______________________________________  _____________________
MKBCR Representative’s Signature                               Date

- - - - - - - - - - - - - - - - - - - - - - - - - -     MKBCR USE     - - - - - - - - - - - - - - - - - - - - - - - - - -
Spay/Neuter was performed on: __________   Documentation received on:________
Deposit was Returned:  Deposit Returned □   Check destroyed:  □  Check donated:  □
_____________________________________                 _______________
Treasurer Signature                                                                             Date

Revised 04/10

Copyright © 2003 Mo-Kan Border Collie Rescue, All Rights Reserved.