Adoption Application

Printer
Please fill out all fields to the best of your ability, thank you.
Name:
Street Address:
City: State: Zip:
Email Address:
Home Phone: Cell Phone:
Work Phone: Extension:
Driver's Licence #: Expiration Date:
If renting, do you have your landlord's permission to have animals? Yes No Not renting
Landlord's Name Phone #:
How many people live in your house?
If any children, list names and ages:
Does anyone in your household smoke? Yes No If so, where do they smoke?
Do you have any animals currently? Yes No
If so, list by species:
Please tell us about your level of experience with animals:
Personal reference: Please provide the names and phone numbers of two people:
Have you ever had to give up a pet? What was the reason for doing so?
Have you ever been arrested or charged with a misdemeanor? Yes No
If yes, please explain:
Have you ever been arrested or charged with DUI/Domestic Abuse/Animal Cruelty? Yes No
Do you use recreational drugs? Yes No
Do you have any health issues or take medications that we should know about?
Do you currently use a veterinarian for your pets? Yes No
Clinic or Veterinarian: Name:
Address:
Phone #:
If you go on vacation, who takes care of the animals?
Pet Sitter: Name:
Address:
Phone #:
Please write in any additional information you feel we should know about you:

Cali_FID Parrot & Exotics Rescue Sanctuary always accepts returns. If for any reason the adoption does not work, you may contact us to arrange the return of the adopted animal(s). You understand that no refund of adoption fees will be given.

By signing, you agree to waive all rights of subrogation against Cali_FID Parrot & Exotics Rescue Sanctuary. You agree to hold Cali_FID Parrot & Exotics Rescue Sanctuary, its volunteers, agents, and board of directors, harmless for any and all claims. You understand and agree that you may be adopting an animal(s) with possible behavioral issues, medical issues, loud vocalizing, or other situations that are beyond our control, and that we may have been unaware of. You understand that animals can develop issues that they did not have prior to adopting.

Your electronic signature serves as acknowledgement that this is a sincere inquiry and that all information provided is true, correct and complete. On the Internet, an Electronic Signature carries the same legal weight as if you were signing your name to a printed document.

To finish submitting this form, please provide your electronic signature below by typing your full name in the box provided, then submit the form.

Electronic Signature: Date: