Adoption Contract

PEKINGESE CHARITABLE FOUNDATION, INC. (PCF) – ADOPTION CONTRACT

I, the undersigned, have adopted:

Name of

Pekingese__________________________________________________________________

Sex_______________Age_________________Color__________________

AKC Reg.#_______________________ from the Rescue Program. (Use a separate form

for each Pekingese)

Upon release of this Pekingese to me, I will do the following:

1. Provide this Pekingese with kind and loving treatment at all times.

2. Provide proper and sufficient food, water, shelter when outside and identification

3. Provide this Pekingese with periodic veterinary care, including:

Immunizations and heartworm testing at my expense.

4. Agree this Pekingese is to live indoors (not in the garage or basement, etc.)

5. Provide this Pekingese with exercise. I have a fenced yard or will provide an

enclosed exercise area.

6. To comply with all state and local ordinances governing the licensing and ownership

of dogs.

7. If unable to keep the animal for any reason, I agree to contact a PCF volunteer

immediately so that proper arrangements can be made to pick up the Pekingese, and I

will surrender the Pekingese to a PCF volunteer for return into the PCF Rescue

Program.

8. If behavior problems arise, I agree to make reasonable attempts to relieve the

problem.

I accept the dog as is and assume all risk and financial responsibilities of ownership. I

release PCF from any and all liability associated with any illness of the dog or damage or

injury hereafter caused by the dog. I understand that some of the information provided on

the adoption application regarding the dog may have been received by PCF from a third

party. I understand that PCF does not warrant the accuracy of such information. I agree to

return this dog to PCF, making no charges of any nature for licensing, care, food, or other

services or items. I agree to pay any reasonable attorney fees and court expenses if PCF

must bring legal action against me to enforce this adoption agreement. I understand that

any sum of money I have given to PCF is to be used in caring for dogs in the rescue program

and is NOT refundable. A separate contribution made to the Pekingese Charitable Foundation

which is not for the adoption of a dog is tax deductable.

Signed______________________________________________________Date__________

Please print:

Name:_____________________________________________________________________

Address:___________________________________________________________________

City, State, Zip: ____________________________________________________________

Zip:_________________

Telephone, Fax: ___________________________________

E-Mail________________________________________________________________

PCA is a non-profit organization assisting in the rescue, foster and placement of dogs into

suitable homes. Thank you for caring to adopt. We rely on donations to offset costs

associated with these activities. PCF requests a donation of $150.00 to $200.00 to defray

the veterinary expenses incurred in preparing your Pekingese for adoption. This donation

is not tax deductible. Any additional donation you would care to make is greatly

appreciated.

this application may be printed, filled out and faxed, mailed or copied to Word, fill out in Word and

attached to an e mail to:

Sue Lewis

121 Otari Drive, Kingsport, TN 37664-5200

423/378-3091 otaripekes@aol.com