Adoption Form

Adopter's Information

(if rural, list both physical & mailing address)

By my signature below, I agree to the following terms and conditions:

  • I am 18 years of age or older and am adopting the animal described as my own companion animal.
  • I will treat this animal humanely and give adequate food, water, shelter and emotional stimulation throughout his or her life.
  • I will keep this animal safe from harm and undue stress and will not permit any testing or vivisection to be done on the animal.
  • I understand the Pembina Valley Humane Society (PVHS) can examine the animal and investigate the conditions under which it is kept on my property at any reasonable time of day. In the event the PVHS concludes that the animal has or is being neglected, abused or mistreated, I agree to surrender the animal to the PVHS immediately upon demand.
  • The animals at PVHS have been attended by a qualified veterinarian and PVHS strives to ensure that they are in optimal health at the time of their adoption; however, on rare occasions an animal may be affected by a condition or illness that has not been detected by standard shelter practices. I acknowledge that no health or behavior guarantees have been offered.
  • I acknowledge the PVHS is not responsible for any veterinary fees incurred after adoption has been finalized.
  • I acknowledge that the breed specified for the animal I am adopting is a “best guess” and cannot be guaranteed to be accurate.
  • I understand that if I wish to return the above animal to PVHS within 10(ten) days of the date of this document, I will receive a full refund of the fees charged at the time of adoption. I understand that the PVHS will not issue a refund after 10(ten) days of the date of this document, but should I wish to return the animal, I will not be charged a surrender fee at that time.
  • I agree to return the animal to PVHS on the scheduled date to have the animal sterilized.
  • I confirm that I have never previously owned this animal nor have any family members.
  • I understand and acknowledge that the PVHS does not support or condone mutilations such as declawing, tail docking, ear cropping or any other medically unnecessary mutilation.
  • In the event that I am no longer able or willing to care for the animal, I cannot sell the animal or place it in the care of another individual, pound facility or rescue, but must return the animal to the PVHS. I will not be required to pay any additional fees at that time OR if I have found a new owner for the animal, I agree to contact the PVHS prior to the new owner taking custody of the animal and process a change of ownership, which is subject to the approval of the PVHS.