waiver

Parent Name *
Parent Name
Phone *
Phone
Address *
Address
Employment Address *
Employment Address
Do you already have a shelter animal selected? *
If yes, is your animal a dog or a cat?
If yes, what is the shelter's address?
If yes, what is the shelter's address?
If yes, what is the shelter's phone?
If yes, what is the shelter's phone?
Pledge *
I certify that my child is a Survivor of sexual assault and/or domestic violence. I certify that I am at least 18 years of age. I pledge to make a reasonable commitment of time and effort, and to affect scheduling and lifestyle changes in order to make this relationship with my pet work. I pledge to provide appropriate and timely veterinary care for the life of my pet. I pledge provide my pet with the proper nutrition for optimum health, and to keep my pet the proper weight, neither obese nor emaciated. I pledge to give my pet ample aerobic exercise daily, and make sure that at least three times a week they get to run and play and get tired out. I pledge to provide my pet with mental stimulation in the form of either play, interactive toys, training, or off territory leash walks, DAILY. I pledge to provide my pet with enough training and/or behavioral management so as to enable him to be a welcome part of my community, or managed safely. I pledge that if, for any reason, I can no longer keep this pet, I will not abandon them, and I will return to the shelter (if required) or leave ample time to find a new, appropriate home, tell the new owners truthfully all the pet’s behaviors, good and bad, and follow up occasionally to make sure the pet is safe and content.