YORKIE FRIENDS RESCUE

YORKIE FRIENDS RESCUE CORPORATION

Adoption Agreement Contract

Dog’s name:_____________________ Foster #:________________

Adopter’s Information:

Name: ____________________________________________________

Address: __________________________________________________

Home Phone: ______________________________________________

Cell Phone: ________________________________________________

Yorkie Friends Rescue Representative:

Name: ______________________________________________________________

Address:_____________________________________________________________

Phone:___________________________

Date of Adoption:_________________

Adoption Donation:________________

Identification of Dog:

Dog’s name: ________________ Age: ___________D.O.B.__________ Sex: _________

YFR. Microchip Number: ______________________________________________

Health Status:

It is the policy of Yorkie Friends Rescue that all dogs be altered before adoption. If the following medical procedures are not current, they become the responsibility of the new owner.

Is this pet altered? _________ Date Neutered/Spayed: _________ Dental: __________

Veterinarian certificate for N/S provided? ___________

Dates of:

Rabies__________ DHP/Parvo__________ HW Test__________ Fecal___________

Other Tests/Procedures:__________________________________________________

HW Preventative________ Brand___________________________

Flea Preventative________ Brand___________________________

Name of Vet Clinic/Vet Where Records May Be Obtained: ______________________________________________________________________

Address:_______________________________________________________________

Phone:_________________________________________________________________

Evaluation of Dog:

This dog has been examined by a Veterinarian and found to be in good health with the following exceptions:______________________________________________________

________________________________________________________________________________________________________________________________________________

________________________________________________________________________

In the time this dog has been living with a YFR representative awaiting adoption the representative has observed the following behavior that may have an impact on the dog’s ability to adjust and thrive in his new home or that may be of interest to the Adopter: ___

________________________________________________________________________________________________________________________________________________________________________________________________________________________

________________________________________________________________________

1. Yorkies are typically affectionate, friendly and have sound temperaments. We will not place a dog known to have an unsound temperament. However, no one can predict how any dog will react in a given situation, especially without complete knowledge of the dog’s past. Therefore, adoptive owners are strongly urged to exercise caution when introducing the adoptive Yorkie into their home and to monitor the dog’s behavior until the dog has had sufficient time to become fully acclimated to its new environment and the adopter has had sufficient opportunity to become familiar with the Yorkie’s personality.

2. No Yorkie will be placed in a new home that does not provide a fenced area or an enclosed run, which can be entered through a door from the house. A Yorkie must never be allowed to run loose and should always carry identifying tags or tattoos with an identifying name and number. Apartment dwellers must agree to walk the dog on a leash, as Yorkies have no regard for street traffic.

3. If the adoptive owner cannot, for any reason, keep the dog they must notify the YFR representative or national president, and give the YFR the option of reacquiring the Yorkie.

4. The placement of a Yorkie in a home with another pet must be discussed with the YFR representative. As Yorkies often display dominant traits toward other pets, not all breeds of dog make suitable living companions. This is especially true for older Yorkies and pets.

5. YFR makes no representations or warranties regarding the temperament or physical condition of any adoptive Yorkshire Terrier. ALL WARRANTIES, INCLUDING IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE, WHERE THEY ARE APPLICABLE, ARE HEREBY SPECIFICALLY DISCLAIMED.

6. YFR shall not be responsible for any bodily injuries or property damage caused by any adopted Yorkshire Terrier or by the actions of its adoptive owners. The adoptive owner hereby specifically assumes sole responsibility for, and agrees to hold YFR and its representatives harmless from, any and all loss and expense (including legal fees) by reason of liability imposed by law upon YFR. and its Rescue representatives, because of bodily injuries to any person or persons including the adoptive owners, or any damage to property arising out of consequences of the placement of this Yorkshire Terrier, howsoever such injuries or damage to property may be caused, or may be alleged to have been caused by negligence of the aforementioned parties or any of their employees, agents, members or any other person.

I have read the preceding and agree to the conditions set forth.

Signature of Adopter: Date:

_________________________________________ _______________________

Signature of YFR Representative

_______________________________________ ______________________

Note: This document consists of three (3) pages.