Adoption Deposit Form – Adams County Pet Rescue – A Pet Shelter Serving Adams County

Fill out this form after you have been approved for adoption in order to hold the animal for you. We need the deposit form filled out and PayPal sent in the amount of $105 as soon as possible.

There is an Adoption Deposit per animal that must accompany this form. This deposit of $100.00 Plus a card/online fee of $5.00 is required for each animal you wish to adopt. Cash, credit/debit cards, or online payments may be used to pay the deposit and balance due at the time of the animal(s) pickup. Your $100.00 deposit will be deducted from the animal(s) adoption fee, which is due at time of pickup. Please read and Initial in front of the statement that you acknowledged you understand the statement. *

If you back out of the adoption your deposit will be forfeited and it will be considered a donation to the Adams County Pet Rescue.

If the adoption does not go through due to circumstances beyond your control it will be decided by the ACPR whether to refund the deposit.

If the animal becomes sick, dies, or is reclaimed by its owner, the deposit will be refunded or applied to the adoption fee of another animal.

If you are unable to pick up the animal within two days of it being ready for pick up there will be a $20 per night boarding fee applied to your adoption total.

By signing this form, you acknowledge that you understand the terms of this application deposit. If you have questions, please ask before signing this form.

Name *

First

Last

Date of Deposit *

Adoption Amount *

Deposit Amount *

Main Phone *

Other Phone

Email *

Name of the animal that you are adopting *

Date & time of pickup *