Please print out the following pages and fill out all information

Tri- County Animal Rescue Center
Route 322
Shippenville, PA 16254
814 – 918 – 2032

STATEMENT OF UNDERSTANDING

Agree to maintain on monthly flea/tick preventatives.

You are financially able to care for animal.

You agree to provide adequate shelter.

You agree to provide adequate food/hygiene/companionship.

I understand that submitting an application does not guarantee that I will
be approved for adoption. Tri- County Animal Rescue Center and/or their
authorized representative(s) reserve the right and authority for the final
approval and disposition on the placement of animals under their care.

I certify that the information provided on this form is true and correct.
I am also financially and physically able to care for the animal that I wish
to adopt. I understand that proper food & veterinarian care can be costly
and I am able to meet these requirements. I understand that any adoption fee
paid is nonrefundable.

By signing below, I acknowledge that I have completely read this
questionnaire, comprehend it fully, and know that applying does not ensure
approval. I agree that if at some point in time I am unable to care for this
animal, I will return this animal to Tri – County Animal Rescue Center.

I understand that by signing this form I authorized my veterinarian’s office
to verify that my other pets are current on vaccinations and clients of the
veterinary practice.

I will provide the animal with all necessary medical care if it becomes sick
or injured. I will take the animal to a veterinarian for routine exams and
vaccinations.

Should any behavioral problems arise with this animal (e.g. improper
scratching or elimination), I will work with the animal and/or a
veterinarian/behaviorist to resolve the issue.

The animal will live indoors only. I am aware that cats who live outdoors
some or all of the time have significantly shorter life expectancies and
face many more health risks than cats kept indoors at all times.

I understand that if any of the terms of this contract are broken at any
point in the future, Tri – County Animal Rescue Center reserves the right to
remove the adopted animal from my home.

You affirm that everything you have stated is true.

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