Golden Retriever Club of Hawaii

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The Golden Retriever Club of Hawaii, Inc.
Adoption Application

The Golden Retriever Club of Hawaii, Inc (GRCH) is a non-profit, licensed AKC Specialty dog club. We ask a $50 non-deductible adoption donation for all rescue dogs and an agreement from the adoptive family to spay or neuter the dog at their own expense. GRCH does its best to place healthy dogs with good temperament with adoptive families. All dogs will be examined and, if required, vaccinated by Dr. Darin Hisanaga of the Waipahu Leeward Veterinary Clinic prior to placement. However, because the background of most rescue dogs is unknown, GRCH makes no guarantees relating to such health or temperament. A signed General Release is mandatory with all adoptions.

NAME:
ADDRESS:
CITY:	STATE:	ZIP:
HOME PHONE:	WORK PHONE:	CELL PHONE:
E-MAIL ADDRESS:
WHY DO YOU WANT TO ADOPT THIS DOG?

HOW MANY PEOPLE IN THIS HOUSEHOLD?

IF THERE ARE CHILDREN IN THE HOME, WHAT ARE THEIR AGES?

DOES EVERYONE WANT A DOG? YES NO

WHO WILL BE THE PRIMARY CAREGIVER?

DO OTHER ANIMALS LIVE IN OR VISIT THE HOME? YES NO

IS SO, PLEASE EXPLAIN:

DO YOU OWN OR RENT?

IF YOU RENT, DO YOU HAVE WRITTEN PERMISSION FROM THE LANDLORD TO HAVE A DOG? YES NO N/A

DO YOU AGREE TO A HOMECHECK? YES NO

WILL THE DOG BE MOSTLY INDOORS OR OUTDOORS?

WHERE WILL THE DOG SLEEP?

DO YOU HAVE A DOG DOOR? YES NO

DO YOU HAVE A COMPLETELY FENCED IN YARD? YES NO

IF SO, HOW HIGH IS THE FENCE?

IS THERE SHELTER OUTSIDE (SUCH AS A COVERED LANAI) SO THE DOG CAN GET OUT OF THE SUN AND RAIN? YES NO

EXPLAIN:

HOW WILL YOU EXERCISE YOUR DOG?

WILL YOU TAKE YOUR DOG TO ORGANIZED OBEDIENCE CLASSES? YES NO

DO YOU HAVE A POOL? YES NO

IF SO, IS IT SEPARATELY FENCED? YES NO N/A

ON AVERAGE, HOW MANY HOURS A DAY WILL THE DOG BE ALONE?

IF THE DOG IS NOT HOUSEBROKEN, HOW WILL YOU HOUSEBREAK?

HAVE YOU HAD DOGS BEFORE? YES NO

WHAT HAPPENED TO THEM?

WHAT WILL YOU DO IF YOUR DOG DESTROYS SOMETHING?

HOW WILL YOU DISCIPLINE YOUR DOG?

DO YOU HAVE A VETERINARIAN? YES NO

WHAT WILL YOU DO WITH YOUR DOG IF YOU LEAVE THE ISLANDS?

UNDER WHAT CIRCUMSTANCES WOULD YOU GIVE UP YOUR DOG?

RESCUE DOGS WILL BE SPAYED OR NEUTERED AT OWNERS EXPENSE. DOGS SHALL NEVER BE TETHERED TO A TREE OR FENCE EXCEPT FOR TEMPORARY SAFETY REASONS DURING SUCH ACTIVITIES AS TRAINING OR PARK OUTINGS. FURTHERMORE, THE DOG WILL NEVER BE TIED TO A DOG RUN OR TRANSPORTED IN THE OPEN BED OF A TRUCK. WOULD YOU AGREE TO THESE CONDITIONS? YES NO

I (we) have read the terms of this GENERAL RELEASE and I (we) fully understand them. I am (we are) of lawful age and legally competent to sign this GENERAL RELEASE and I (we) enter into this GENERAL RELEASE voluntarily.

TYPING IN YOUR NAME BELOW CONSTITUTES YOUR SIGNATURE.