Email Adoption Contract

Please copy the text below and paste into an e-mail message.  Complete all areas, including the agreement consent at the end of the form, and send to one of the following. 

For cats: 

For dogs:

Please Note: You will be asked to sign a copy of this contract prior to completing the adoption

* Required

Your Name *

Address *


Home Phone

Cell Phone

Work Phone and Extension


Landlord Name and Phone Number (if renting) *

Present and past veterinarian's name and phone number for you and any roommates that have pets.  Please include the name of both the owner and of the pets. *

Pet to be adopted

Type of Animal (Cat, Dog, Other) *

Name *

Age *

Sex *


Please provide contact information for up to three references (at least two are required). A phone number and/or email address is required for each reference. Only one relative (who does not live with the applicant) is permitted.

Reference 1 *

Reference 2 *

Reference 3


I agree to keep an ID on the adopted animal at all times, whether inside or outside of the house, and to obtain all of the necessary licenses required by local authorities. I agree to provide the adopted pet with necessary inoculations/heartworm treatments at the intervals advised by my veterinarian. I agree to have the adopted pet under my control when it is not on the confines of my property. 

The adopted pet will not be tied or chained. I agree to provide nutritious food and a continuous supply of clean water. 

If the adopted pet is a cat, I agree to keep the cat as an indoor- only pet. I agree NOT to have the cat declawed; understanding that declawing is a painful amputation of the terminal bone at the joint, and would be mutilation of the cat's paws.

If, for any reason, I cannot keep the adopted pet, I agree to notify the Riley County Humane Society (RCHS) at the above address and phone number, and return the adopted animal to an active member of the organization. I understand that any failure to perform the foregoing agreement will constitute a breach of contract. In the event of a breach in contract, I authorize the Riley County Humane Society to reclaim both possession and ownership of the pet. I understand that the pet covered by these adoption papers, is, as far as can be determined by the RCHS, in good health, and that the RCHS is not responsible for any medical fees incurred after the adoption date. However, if a health problem develops during the first 10 days, I should notify the RCHS to discuss the matter. I agree to provide requested feedback in the adoption follow-up program, and I give the RCHS visitation rights to ensure that the terms of this adoption agreement are being observed.

Do you agree to the above provisions? 

(You will be asked to sign a copy of this contract prior to completing the adoption)