UNITED STATES KERRY BLUE TERRIER CLUB, INC.

ADOPTION AGREEMENT

1. The Adopter shall take the animal to a veterinarian within three (3) days of the date of this Agreement for a checkup, shots, and medication recommended by the veterinarian. USKBTC makes no representations or warranties as to the health of the animal.
2. If not already neutered, Adopter shall have the animal neutered or spayed no later than ninety (90) days from the date of this Agreement.
3. Adopter shall provide the animal with humane care and maintain it in accordance with all current and future state, county, and municipal laws and ordinances where the Adopter resides.
4. Adopter shall provide the animal with necessary veterinary care upon sickness, disease, or injury, and shall take it to a veterinarian at least once a year for an annual health examination and routine vaccinations.
5. The Adopter shall provide the animal with a fully fenced yard or other humane means of exercise. The animal shall not be kept constantly chained or left outside without human supervision.
6. If the Adopter cannot keep the animal, the Adopter shall notify the USKBTC immediately. The animal shall not be sold, transferred,relinquished to a shelter or rescue group other than the USKBTC, or given to any individual or to any retail or wholesale establishment for the purpose of sale or resale to the public, nor to any research institution where medical experimentation or other experimental practices take place.
7. The animal shall reside at the Adopter’s address
8. The Adopter shall keep the animal as a household pet and shall not use it for breeding or exclusively as a guard dog.
9. The Adopter shall provide a collar and identification tag for the animal to wear at all times when allowed to go outdoors.
10. The Adopter shall pay an adoption fee (DONATION) of $________________.
11. The adopter understands that the USKBTC and its representatives have limited information regarding the temperament or habits of the animal described below. The Adopter agrees that it is the Adopter’s responsibility to accept the animal as described.
12. The Adopter, does hereby release, discharge and hold harmless the United States Kerry Blue Terrier Club, Inc. (USKBTC), and any other person, firm or corporation charged or chargeable with liability, their heirs, administrators, executors, successors, and assigns, from any and all claims, damages, costs, expenses, loss of services, actions and causes of action, whether known or unknown, belonging to the said Adopter arising out of any action or occurrence from the date of this contract arising out of or in connection with the adoption of the animal described below.
13. The Adopter agrees to pay USKBTC any and all expenses, including court costs and reasonable attorneys fees, in enforcing the terms and provisions of this contract.
14. Adopter agrees to pay for all shipping charges, and related expenses, with regard to delivery of the dog to Adopter.
15. Adopter agrees that the animal is placed on a thirty (30) day trial period. During this trial period, the adoption shall be terminated if the animal is found by a USKBTC representative to be improperly maintained. The Adopter may return the dog at any time during this trial period to a USKBTC rescue representative and receive a full refund of the donation minus any expenses involved in the adoption.

THE UNDERSIGNED Adopter hereby acknowledges have read the terms of this contract and does hereby agree to abide by each of the rules of adoption set forth above.

Dated: ___________________________________

X___________________________________________
Signature of Adopter(s)

X_________________________________________

Witness: _________________________________

Printed Name and Address of Adopter(s)

_________________________________________

_________________________________________

_________________________________________

Phone Numbers:
(______) — ______ — __________
(______) — ______ — __________

INFORMATION ON DOG
(To be completed by representative of USKBTC)
Name: ___________________________________________
Age: ______ Sex: __________ Spayed/Neutered (Circle) Yes No
MICROCHIP# or TATTOO____________________________________
Additional Known Information About Dog: