DOG ADOPTION QUESTIONNAIRE Name: FOR OFFICE USE ONLY Date: Staff Full Name: Shelter: Address: Dog s Name: SB No.: City: Telephone: Postal Code: Cell: Approved: Yes No Pending Reason: Email: ONDL/ID: Birthdate: ( m m / d d / y y y y ) GENERAL INFORMATION 1. Who will have the primary responsibility for this dog? YOUR FAMILY 1. Who are you adopting this dog for? Myself Other: 2. Number of adults (18 + years) at home: 3. Number of children at home: 0 7 years 8 17 years 4. Any visiting children? 2. Have you had dogs before? 3. What happened to them? 4. Have you surrendered or given away a pet? If yes, please provide the reason: 5. Any allergies in the family? 6. How busy is your family s schedule? Very busy Busy Not busy 7. How would you describe yourself? Nervous Loud Calm Quiet 9. Are you planning on the following in the next month? Moving Holiday Change in schedule 10. Where will your dog stay during holidays? At home with care Boarding Other YOUR HOME 1. What type of home do you live in? Acreage House Apartment 1a. What type of yard do you have? Fenced Unfenced No yard 2. Do you: Own Rent 3. Do you have your landlord s/strata s permission to have pets? Please provide us with contact information for your landlord or a copy of your strata by-laws: Checked by the DOG TALES Yes, please initial: 4. On average, how many hours will your dog be alone on: Weekdays Weekends 5. Where will your dog stay during the day? Loose in the house Crated inside Garage Fenced kennel/run Fenced yard Loose outside Other 6. Where will your dog stay during the night? Loose in the house Crated inside Garage Fenced kennel run Fenced yard Loose outside 5. How many hours of exercise can you give your dog? Weekdays Weekends 6. What would you enjoy doing with your dog? On-leash walking Off-leash walking Off-leash parks Jogging Cycling Other 7. Approximately how much do you think your dog will cost you per year? Vet/medical Boarding YOUR PETS Food Grooming 1. Are there other dogs in your household? If yes, please list them: Name Breed Age Sex Fixed? 2. Do you have other pets in your household? If yes, please list them: Name Type Age Sex Fixed? 3. Please provide the name and phone number of your vet:
DOG TALES ADOPTION QUESTIONNAIRE TELL US WHAT YOU ARE LOOKING FOR Sex: Female Male No preference Coat: Short Medium Long Non-shedding No preference Age: Puppy Adult Senior No preference Size: Small Medium Large No preference Breed/Type/Colour: PROBLEMS YOU ARE WILLING TO WORK ON Separation anxiety Excitability Mild aggression Obedience House training Fearfulness Reaction to other dogs Barking Vocalization I am not willing to work on any problems I need more information to decide I WOULD LIKE MY DOG TO: VERY IMPORTANT QUITE IMPORTANT NOT IMPORTANT Be friendly with children Be friendly with other dogs Be friendly with cats Be friendly with me Be friendly with visitors to the house Enjoy being groomed Enjoy being held Enjoy being petted Be calm Be playful Be quiet Be independent Never wake me up at night Never show aggressive behaviour SOME DOGS WILL REQUIRE TRAINING YES NO NOT SURE I need a dog that is already trained I am first time dog owner I have obedience trained before I have lots of experience and could handle a difficult dog Under what circumstances would you return your dog? Moving Too costly New baby Aggression Medical reasons Not enough time Behaviour problem Comments: Have all the members of your household met the dog? Have you ever been convicted of neglect or cruelty to animals? Are you willing to have a DOG TALES representative do a home visit by appointment? If not, why? FALSIFIED INFORMATION WILL LEAD TO AUTOMATIC REJECTION OF THE APPLICATION. DOG TALES RESERVES THE RIGHT TO REFUSE ANY APPLICANT. I understand that it is my responsibility to see and evaluate the dog for myself before agreeing to adoption. The adoption of a lifelong animal friend should not be impulsive, but rather a carefully thought out decision, which will ensure a loving, lasting relationship. Applicant signature: Date: THANK YOU FOR COMPLETING THIS QUESTIONNAIRE. THIS INFORMATION WILL HELP US MATCH YOU WITH THE RIGHT DOG FOR YOUR FAMILY. DOG TALES ADOPTION FEE FOR ALL PETS IS $375 PLUS HST
DOG TALES ANIMAL ADOPTION AGREEMENT THIS AGREEMENT is made as of the date written below between Dog Tales and the adopter(s) (the Adopter ) of the animal(s) described in the attached Dog Tales Adoption Form (the Animal ). Dog Tales and the Adopter are referred to herein each as a Party and collectively as the Parties. WHEREAS the Adopter wishes to adopt the Animal from Dog Tales; AND WHEREAS the Parties wish to state the duties and obligations of Dog Tales and the Adopter, respectively, concerning the Adoption and care of the Animal. IN CONSIDERATION OF the Adoption Fee and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the Parties agree as follows: 1. Specific Acknowledgments (Adopter to Initial Each Statement) a. The Adopter has been informed that all animals can, from time to time, possess medical conditions that may be undetectable in what appears to be a healthy animal at the time of Adoption. These conditions can include, but are not limited to, bacterial, viral, parasitic, and fungal diseases (e.g. ring- worm), some of which can affect humans. Dog Tales will not be responsible for costs incurred after Adoption in relation to Animal health issues including but not limited to treatments. b. The Adopter is aware that pets may exhibit normal but potentially undesirable behaviours including, but not limited to: aggression, house soiling, biting, scratching (people, furniture and woodwork), digging and urine spraying; and that these behaviour patterns may be difficult to manage. Dog Tales provides no warranty or assurance with respect to the behaviour of the Animal. c. The Adopter is financially able to meet the expenses required to care for the Animal including veterinary costs. d. The Adopter has read and fully understands the entirely of this Agreement. 2. Fees. The Adopter agrees to pay a non- refundable fee of three hundred and seventy five dollars ($375.00) to adopt the Animal (the Adoption Fee ). Subject to the provisions of this Agreement, ownership of the Animal shall pass to the Adopter upon the later of the payment of the Fee and the delivery of the Animal by Dog Tales to the Adopter (the Adoption ). Delivery and completion of the Adoption of the Animal is at the sole and absolute discretion of Dog Tales. 3. Free Training Session. Upon the payment of the Fee, the Adopter will be entitled to one (1) free training and consultation session with Dog Tales in- house behaviourist. Additional training and consultation sessions may be made available to the Adopter(s) at the applicable advertised rates. 4. Medical Care. The Adopter hereby agrees to be fully responsible for the physical and medical care of the Animal at all times after Adoption, including but not limited to the payment of all veterinary costs. Notwithstanding the foregoing, should it be determined that a female Animal has not been spayed prior to Adoption, Dog Tales will spay the Animal at its own expense. 5. Return of Animal. If the Adopter does not wish maintain possession of and care for the Animal, the Adopter hereby agrees to promptly return and relinquish ownership of the Animal to Dog Tales. The Adopter shall not transfer ownership or long- term care or control of the Animal to a third party without the written consent of Dog Tales. If Dog Tales learns that the Adopter is not
adequately caring for the Animal, is otherwise neglecting the Animal or intends to euthanize the Animal, Dog Tales may, at its sole and absolute discretion, demand, and the Adopter shall, promptly, return the Animal and relinquish ownership to Dog Tales. The Adopter will not be provided with a refund of the Adoption Fee. 6. Bonded Pairs. Unless otherwise agreed upon by the Parties in writing, when two or more animals are Adopted together (a Bonded Pair ), they shall at all times remain living together in proximity to and regularly socializing with one another. Should the Adopter fail to keep a Bonded Pair together on an ongoing long- term basis, at the option of Dog Tales, upon demand, the Bonded Pair (or part thereof, as applicable), shall be promptly returned and ownership relinquished to Dog Tales. Should part of a Bonded Pair be returned to Dog Tales, the other animal(s) in the Bonded Pair shall also be returned and ownership relinquished to Dog Tales. 7. Euthanasia. The Adopter agrees not to euthanize the Animal except in the event of the terminal illness or injury of the Animal, or, old age accompanied by pain and suffering, as determined by a licensed veterinarian. Only a licensed veterinarian may euthanize the Animal. Failure to comply with this provision shall result in the Adopter being responsible to pay Dog Tales, as liquidated damages, and not as a penalty, an amount equal to fifteen thousand dollars Canadian ($15,000.00). 8. Breach. In the event of Breach of this Agreement, except as otherwise contemplated herein, Dog Tales shall have, in addition to all other rights, remedies, and causes of action, a right of recession, which, for additional clarity, shall include, upon demand, the prompt return of the Animal and relinquishment of ownership to Dog Tales. 9. Acknowledgment and Release. While Dog Tales has taken every reasonable precaution, it cannot guarantee the health or disposition of the Animal. Dog Tales is not responsible for any damage, which the Animal may inflict on another person, property of the Adopter or any other third party. The Adopter accepts the Animal as- is at the time of Adoption and understands that Dog Tales is not responsible for any medical or behavioural conditions not readily detected or detectable to or at the time of the Adoption, or otherwise. At no time will Dog Tales be responsible for any expenses incurred following Adoption, including for veterinary care or the services of an animal behaviourist. The Adopter hereby releases, discharges and holds harmless Dog Tales, its directors, officers, employees, representatives, volunteers, agents, subsidiaries, parents, affiliates, agents and representatives (the Dog Tales Parties ) from any and all liability that may result from the Animal, including but not limited to all incidents related to the Adoption, illness, injury, damage of property, aggressive behaviour, biting, scratching and/or the attacking of the Adopter or other people or animals. 10. Dog Tales Makes No Representations. The Adopter hereby declares that no representations about the nature of the Animal, nor any representation regarding the nature and extent of legal liability or financial responsibility have induced the Adopter to execute this Agreement. 11. Representations of Adopter. The Adopter, represent that he/she/they have (a) never been subject to legal action for cruelty to or neglect of animals; or, (b) never owned an animal which was confiscated by any animal control or humane organization for violations of animal control regulations or animal adoption agreements. 12. Background Checks. The Adopter hereby consents to the completion of background and criminal checks, which may include: (a) employment inquiries; (b) reference checks; (c) credit inquiries; (d) education verifications; (e) identification cross- checks; (f) credential verifications; and (g) criminal record checks to determine the suitability of the Adopter(s) to adopt the Animal. In addition, the Adopter hereby consents to a visit by a representative of Dog Tales to evaluate the suitability of the Adopter. The Adopter acknowledges that Dog Tales shall determine the suitability of the Adopter, in its sole and absolute discretion. 2
13. Confidentiality. To the greatest extent permitted by law, the Adopter shall not at any time disclose to any person or entity, any information of a non public, confidential or proprietary nature in relation to Dog Tales and this Agreement, including but not limited to the terms herein. 14. Non- Disparagement. The Adopter agrees to take no action which is intended, or would reasonably be expected, to harm Dog Tales or its reputation or which would reasonably be expected to lead to unwanted or unfavourable publicity. 15. Assignment. This Agreement may not be assigned by the Adopter without the written consent of Dog Tales. Dog Tales may assign this agreement upon the provision of notice in writing. 16. Waiver. No delay or failure by either party to exercise any of its powers, rights or remedies under this Agreement will operate as a waiver of them, nor will any single or partial exercise of any such powers, rights or remedies preclude any other or further exercise of them. Any waiver to be effective must be in writing. 17. Severability. If any part of this Agreement is found by a court of competent jurisdiction or other competent authority to be invalid, unlawful or unenforceable then such part will be severed by the remainder of this Agreement, which will continue to be valid and enforceable to the fullest extent permitted by law. 18. Arbitration. All disputes arising out of or in connection with this agreement, or in respect of any legal relationship associated with or derived from this agreement, with the exception of claims for libel or slander, will be finally resolved by arbitration under the Simplified Arbitration Rules of the ADR Institute of Canada, Inc. The Seat of Arbitration will be Ontario. The Arbitration will be conducted in Toronto or as otherwise mutually agreed upon. The language of the arbitration will be English. 19. Entire Agreement. The Adopter acknowledges that no reliance is placed on any representation made but not embodied in this Agreement. Except as otherwise permitted by this Agreement, no change to its terms will be effective unless it is in writing and signed by persons authorized on behalf of both Parties. 20. Jurisdiction. This Agreement will be construed in accordance with and be governed by the laws of the Province of Ontario and each party agrees to submit to the exclusive jurisdiction of the courts of Ontario. IN WITNESS WHEREOF, the parties have executed this Agreement as the day of, 20. DOG TALES ADOPTER Per: Name: Signature: I have the authority to bind the Corporation Signature: I have the authority on behalf of all adopters to execute this Agreement 3