SPCA in Cattaraugus County Inc.

Foster/Permanent Adoption Application

Thank you for your interest in a foster/permanent adoption of a farm animal
rescued by The SPCA in Cattaraugus County. Our goal is to find the best
possible homes for these animals. To help us in meeting that goal, please
answer the following questions to the best of your ability. Your accurate
responses will also help us to match you with a farm animal that meets your
requirements. ** Note this agreement and its questions are intended
for the protection of the animal, NOT to keep you from
owning/fostering one**
Do you wish to:___________ Foster ___________Adopt
to Adoption.

____________Foster

Name/Description of farm animal You Wish To Foster/Adopt:

YOUR CONTACT INFORMATION

Name: ____________________________________Age:____________
Address: ______________________________________________________________
Phone(s):________________________________E
mail:
________________________________
Please fill out your facility information. Home Location:
# Fenced Acres: # Farm Animals currently on property:
# Owned By You:
# and Size of Stalls:
# and Size of Run-Ins:
Do you own or rent the property where the Farm Animal will reside?
If you rent, please provide the name/telephone number of your
landlord:__________________
_____________________________________________________________________________.
Please tell us why you would like to adopt this farm animal and what your
plans for this animal will be:
Our goal is to place farm animals with people who are committed to lifetime
care for the animals that they adopt. Do you agree to provide care for the
farm animal for the rest of his/her life?
If you are approved, will this be your first farm animal? _______Are you willing
to have an SPCA representative do a property and facility check? _______If
so, what days/times would be most convenient?

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If you adopt what will your expectations of this farm animal be?
What would you describe your level of experience with this type of farm
animal?

Do you currently have any others of this type of farm animal and if so how
many? _________
If you had farm animals in the past, please tell us what they were used for
and why you do not have them now?
Have you ever sold a farm animal at auction? (PLEASE be Truthful). What
was the result, if you know?
Have you ever surrendered an animal to the SPCA or like agency? If so, why?
HEALTH AND WELL-BEING: How much do you anticipate spending yearly
for feed, veterinary, foot/hoof care, dental, and medication, worming meds,
special medical and dietary needs?
If applicable, tell us what vaccines you will have administered to this
fostered/adopted animal and frequency.
Please provide us with your veterinarians information and permission to
contact him/her:
Name and Phone:
Please provide two references, (people Not related to you), who can verify
your ability to provide care to this animal(s):
Name and Phone:
Name and Phone:
Signing this application authorizes contact of the listed references and
inquiry about your experience.
Adopters Initials
Date
If you adopt a pregnant animal, do you agree to provide proper veterinary
care for the animal and offspring at your expense?
Yes
No
N/A
If you adopt an unneutered animal that should be neutered, do you agree to
have an appointment set up to neuter and have that appointment and
neutering verified with your vet by a representative from the SPCA?
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Yes

No

N/A

If needed, do you agree to arrange an appointment with your vet upon

adoption to have the farm animal vaccinated and assistance with a worming
program and any other health issues?
Yes

No

Please initial that you have been advised of all the

following information about the available farm animals for
foster/adoption:
It is understood periodic updates and photos are requested, should you move
or have a change in contact information, e-mail or change boarding facilities
the information will be forwarded, to update records and monitor the
whereabouts, health and safety of the farm animals.
Foster/Adopters
Initials
Date
It is agreed that if said animal is adopted by you and the animal and or its
offspring is to be offered for sale or rehoming in the future, The SPCA of
Cattaraugus County SPCA will be
notified:____________________________________________________Phone::__________
_____________________________e-mail:__________________________________, Text:
_______________________ and that you will give the SPCA the First Right of
Refusal. The SPCA has fourteen (14) days in which to notify you that it will
exercise its First Right of Refusal from the date of notification by the adopter.
If the SPCA opts not to exercise its First Right of Refusal, the adopter shall
require an agreement by the new adopter/purchaser to execute this
agreement as provided below and provide the SPCA with the name, address
and telephone number of any prospective adopter/purchaser to which the
animal may be transferred so that the SPCA may update its records and
monitor the whereabouts, health and safety of the animal.
Adopters Initials

Date

It is further agreed that the animal may not be sold or transferred in any way
into the custody of another person until such person completes a copy of the
Application and Agreement, and the subsequent adopter/custodian shall be
bound by the terms thereof.
Adopters Initials

Date
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It is further agreed that this animal will only be transferred privately and will
not be resold at any type of auction, animal, feed lot or slaughter
destination.
Adopters Initials

Date

In the event the undersigned fails to comply with the terms of this
Application and Agreement, The SPCA reserves the right to commence legal
proceedings to recover the animal, and the undersigned shall be liable for all
costs including damages and reasonable attorneys fees to the SPCA in
Cattaraugus County, Inc. and such costs are assumed at a minimum of
$15,000.00, inclusive of attorneys fees, in connection with such legal
proceeding.
Adopters Initials

Date

This offer is accepted by (must be signed):

Signed_________________________________________ Date________
*Adopter signature warrants that the adopter is at least 18 years of age at
the time of signature and acknowledges receipt of and agreement to the
Terms and Conditions contained within this agreement
The following Release of Liability is to be signed upon approved
application prior to taking possession of the horse or horses.
Release of Liability
I have made no misrepresentation to the SPCA regarding my name, address,
age, experience or any other information that was requested. I agree to hold
harmless and indemnify the SPCA that has organized this adoption for any
loss or damage, including any that result from claims for personal injury or
property damage related to the handling of the animal named on this
adoption application.
Date:

Participant Printed Name:

Participant Signature:
________________________________________________________
(Must be signed)
I have advised that this document is a release of liability and have checked
to make sure that he/she has read this document and understands the
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nature of this document and that he/she is signing this document of his/her
own volition.
WITNESS
_______________________________________________________
WITNESS
PRINTED
____________________________________________________
DATE: ______________________

SIGNATURE:
NAME: