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About the Program  |   Rescue Dogs
 

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

 
GENERAL RELEASE

1. The GOLDEN RETRIEVER CLUB OF HAWAII ("GRCH") operates a rescue program to find suitable placements for Golden Retrievers that need homes.  These dogs will be referred to in this GENERAL RELEASE as "rescue dogs."
2. I (we) have contacted GRCH because I (we) wish to adopt a rescue dog from GRCH.
3. I (we) understand that GRCH tries to determine as much as possible about the background of the rescue dogs that it seeks to place.  Nevertheless, GRCH often does not have information about the conditions in which any particular rescue dog lived, its health, its temperament, and other matters that may be relevant to a decision regarding whether to adopt a rescue dog.
4. As a condition for participating in the GRCH rescue program, I (WE) AGREE TO RELEASE, INDEMNIFY AND HOLD HARMLESS GRCH, ITS OFFICERS, DIRECTORS AND MEMBERS, FROM ANY AND ALL CLAIMS, DEMANDS, DAMAGES, ACTIONS OR CAUSES OF ACTION WHATSOEVER, RESULTING FROM, ARISING OUT OF OR TO ARISE OUT OF, OR CONNECTED WITH, DIRECTLY OR INDIRECTLY, THE GRCH RESCUE PROGRAM.
5. This GENERAL RELEASE applies whether (a) I (we) adopt a rescue dog from GRCH or (b) GRCH decides not to place a rescue dog with me (us), for whatever reason, at the sold discretion of GRCH.

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.
 

 
 

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