I (We) _____________________________, hereby agree to provide a caring home for this (color, sex) ________________ dog, known as ___________, appx.age ________.

I (we) understand that this dog has been spayed or neutered and is heart worm negative. I (we) accept full responsibility for her/his health, welfare and actions. Should I (we) at any time be unable to keep or care for this dog, I (we) will NOT give her/him away or sell her/him to anyone or destroy (euthanize) this dog, but will contact Peggy Dunn, President, or another Pekes and Pals Rescue Representative to return her/him to rescue. I (we) also agree to the following:

1. I (We) understand this is a non-refundable donation, and that we are not purchasing a dog. ________ (initial)
2. To donate $__________ to Pekes and Pals Canine Rescue, Inc. to help defray the cost of the care of this dog and other rescued dogs. (This donation is tax-deductible to the extent allowed by law.) _______ (initial)
3. To keep this dog's vaccinations and heart worm prevention up to date, and if ever sick, to take this dog to a qualified veterinarian. _______ (initial)
4. To provide inside housing at all times. At no time will this dog be housed out of doors. _______ (initial)
5. To provide an adequate amount of quality food and fresh water to maintain this dog in good health, and to groom her/him, or have her/him groomed, regularly to maintain her/his health and comfort. _______ (initial)
6. To never physically or emotionally abuse or let her/him be abused by any other person or animal. _______(initial)
7. To always keep her/him on a leash when she/he is not in a fenced area. To never leave her/him unattended while she/he is in a vehicle. _______ (initial)
8. To treat her/him with love, affection, compassion and kindness. _______ (initial)
9. If she/he is ever lost, stolen or deceased, to immediately, within 24 hours, contact a Pekes and Pals Canine Rescue, Inc. Representative at 239-543-2787. _______ (initial)
10. To notify, within 24 hours, Peggy Dunn of any change of address or location where this dog is being kept. _______ (initial)

This contract is between the adoptive person(s) and Pekes and Pals Canine Rescue, Inc.

In signing this contract, the adopting person(s) agrees to hold the members of the Pekes and Pals Canine Rescue, Inc., and those acting on its behalf, harmless from any liability, expense or cost of defense, resulting from acts of this dog, and any/all problems, consequences or disputes resulting from the adoption of this dog.

My signature acknowledges that I have read and understand this contract and agree to all the above conditions. I understand that Pekes and Pals Canine Rescue, Inc. may reclaim the above named dog from me if I do not fulfill this agreement.

Signed: (Person[s] Adopting dog) _____________________________________________
Address: _____________________________________________Date________________
City:__________________State:_____________Zip:__________Phone:_______________
Email Address:_____________________________________________________________
Signed: (Pekes and Pals Representative)_________________________Date: __________