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Terms and Conditions

By submitting this application for the pet listed below, I agree to the following terms and conditions:

Return the pet to Goliad Pet Adoption Program or assume financial responsibility for all treatment if an illness is diagnosed that was present but undetected at time of adoption. A statement signed by the veterinarian describing the pets condition must accompany a returned pet. Goliad Pet Adoption Program is not responsible for veterinary expenses on or after the adoption date.
Provide fresh food, water, shelter, exercise and other necessary care. and provide permanent, proper and humane care.
Provide shelter at all times. All dogs must have a doghouse and fenced in living area suitable for exercise. No pet should be chained or permitted to roam under any circumstances.
Keep current license and rabies vaccination tags on pet at all times.
Take the pet to a veterinarian on a regular basis. I agree to immediately provide my pet with medical care at my own expense I it becomes ill or injured.
Give the pet all necessary vaccinations and heartworm preventative as directed by my veterinarian.
Permit Goliad Pet Adoption Program to inspect my pets new home when requested and authorize Goliad Pet Adoption Program to remove my pet from my custody if it is found to be receiving inadequate care, abused, neglected, improperly housed or handled, or if there is evidence that any of the provisions of this contract are being violated. If my pet is reclaimed I understand that Goliad Pet Adoption Program will not be obligated to refund the adoption fee or any other expenses incurred by this adoption.

By submitting this application, I release and discharge Goliad Pet Adoption Program from liability for any injury or damage to any person or property caused in the future by this animal and from any causes of action, claims, suits or demands whatsoever that may arise as a result of such injury or damage.

Spay/Neuter

The Texas Health and Safety (Chapter 829) requires that any animal adopted from a shelter MUST BE SPAYED OR NEUTERED.

Adoption Application

Name: *

Co-Applicant's Name

Email Address: *

Email

Confirm Email

(NO work e-mail, personal address only. This is the e-mail address we use to stay in contact with you).

Address *

City *

State *

(choose state from dropdown)

ZIP Code *

Home Phone: *

Alternate Phone:

Employer:

Personal Reference #1:

(name and phone number)

Personal Reference #2:

(name and phone number)

Do you own or lease your home? *

Do you live in an apartment, duplex, or house? *

How long have you lived at your current residence? *

If you lease, do you have a letter or lease stating that you are allowed to have pets?

If you have children at home, what are their ages?

Is everyone in your home in agreement to adopt an animal? *

Yes
No

Where will your pet sleep at night? *

Where will your new pet stay when no one is home? *

Are you willing to purchase a crate and use it for your new dog? *

Yes
No

Do you have a fenced yard? *

Yes
No

(If you do not live in an apartment, a fenced yard is REQUIRED)

What type of yard fence is present, and how tall is it?

What areas are fenced?

Front Yard
Back Yard
Both Front and Back Yard

Select one of the options below that best describes you: *

I'm active and love to be outdoors.
I enjoy reading, computer games, and watching TV/movies.
I would love to have an animal that I can take to the park every day.
I enjoy taking walks around the neighborhood.
I would rather spend my time playing with my dog in my yard.
I'm looking for an easy dog that just wants to be my companion.

Which animal(s) are you interested in adopting?

What makes this animal a great match for you or your family?

List your current pets by NAME, SEX, and AGE:

Are all of the pets listed above current on vaccinations, neutered/spayed, and on monthly heartworm preventative?

Yes
No

What other animals have you had in the past FIVE years, and what happened to them?

(Please be specific, e.g. died (include how), ran away (include how), etc. DO NOT include pets you had as a child)

Under what circumstances would you NOT commit to keeping the dog you adopted? *

I am fully committed to the pet once I adopt them.
If the pet needs more training.
If I had to move.
If I developed a serious health problem.
If I had a child.
If my current relationship with my partner/spouse ended.
Other.

Provide the name of the Veterinary Clinic that you use: *

Veterinarian address: *

Veterinarian Phone Number: *

Do you have any comments that you would like to share or that may help us in approving your application?

Email

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Terms and Conditions

Spay/Neuter

Adoption Application

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