Cedar Valley Boxer
Rescue Adoption Application

No._______________

Dog's Name: ____________________________________________________________Age: _____________

Sex: ________________ Spay/Neuter: __________________________________Date: __________________

Color & Markings: ________________________________________________________________________

Date of vaccinations: ________________________Vet: ___________________________________________

This is an agreement between_____________________________________________________________

and the Cedar Valley Boxer Club Rescue Program. In consideration of a donation of $____________ , by the person
listed above, to the Cedar Valley Boxer Club Rescue Program, the Boxer described above is hereby transferred to it's new owner.

It is agreed and understood that this dog is being acquired as a pet and companion and that it will neither be continuously
tied out nor allowed to run loose. The Boxer will occupy a suitable fenced area with shelter adjacent to the home or it
will be kept in the house.

The new owner agrees to keep this Boxer on Heartworm Preventative and keep all vaccinations up to date.

It is further agreed that this dog will not be sold, given away, destroyed or otherwise disposed of without first notifying
the Cedar Valley Boxer Club Rescue Program and the rescue program will have first option to obtain the dog. The new
owner agrees to release the Cedar Valley Boxer Club, its officers and members and any organizations related to it from any
and all liability or responsibility in connection with this dog.

 

Signature: ___________________________________________

Address: _____________________________________________

____________________________________________________

Phone: ______________________________________________

Email: ______________________________________________

Rescue Member: ______________________________________

Date: _____________________