Little Buddies Adoption and Humane Society

P.O. Box 1543 Centreville, VA 20122-1543 (703) 264-0387

Adoption Agreement for a Dog or Puppy



Little Buddies Adoption and Humane Society (Little Buddies) and the undersigned adopter, ______________________, in consideration of the mutual promises and other good and valuable consideration in this Agreement, intending to be legally bound by this Agreement, agree to the following terms and conditions:



1. The Dog. Little Buddies is placing the following dog/puppy with you, the Adopter, for adoption by you as an indoor dog (the Dog):


Name ______________________________________ Sex : Female 5 Male 5

Color/Markings/Breed/Mix __________________________________________________

Distinguishing Characteristics (if any) _________________________________________

Birth Date _________________________ Spay/Neuter Date __________________

Vaccinations and Dates______________________ De-worming Date ________________

Tested for FeLV: Yes 5 Results: _______________ No 5

Tested for FIV: Yes 5 Results: _______________ No 5

Dog's Veterinarian: _________________________ Telephone ________________




2. Spay/Neuter. If the Dog has not been spayed or neutered prior to this adoption, you agree to enter into a Spay/Neuter Agreement with Little Buddies simultaneously with this Agreement, and to have the Dog spayed/neutered in accordance with the terms and conditions of the Spay/Neuter Agreement.


3. Adoption Fee. Little Buddies requires an adoption fee of $120.00 for the Dog, to help defray Little Buddies' expenses for the Dogs food and veterinary care. In addition, there is an additional $20 fee for any dog/puppy under one year of age. This additional fee is refundable when you show proof that the dog/puppy has completed a dog socialization class. Little Buddies has a very limited budget for rescue work. The adoption fee is not refundable under any circumstances. Any donation, in addition to the adoption fee, which you can make would be greatly appreciated.


4. No Representations. You understand that this Dog was previously unwanted or lost and may have been rescued from a dangerous, unhealthy and/or cruel situation. This could have left long-lasting effects on the dog. You agree that Little Buddies is making no representation or warranties about the temperament, personality or condition of the Dog.


5. Care of the Dog. You agree to provide the Dog with free run of your house, fresh water, wholesome food, adequate outdoor exercise, adequate outdoor bathroom breaks and affection. You will walk the Dog on a leash, or place the Dog in a protected run or other enclosed outdoor area, and never allow the Dog to roam free unsupervised, unless you have an underground electric fence containment system. You will treat the Dog as a household pet, companion and family member, and not leave the Dog chained, cooped and/or otherwise confined for extended periods of time. You agree never to use the Dog for dog fighting or any other sport in which one animal is pitted against another, never to beat or taunt the Dog in order to promote aggressive guard dog characteristics, and never to use the Dog to facilitate hunting, whether as a retriever, chase animal or companion to a person engaged in such activity. You also agree never to strike or harm the Dog.

6. Veterinary Care. You agree to have the Dog examined by a licensed veterinarian within 2 weeks of adoption and not less than yearly thereafter. In case of illness or injury, you agree to seek prompt veterinary care. You agree to keep all required vaccinations current, including but not limited to rabies and distemper, and to ensure that the Dog receives preventative medication to protect against heartworm. You consent to us inquiring with your veterinarian about the Dog after the adoption, and to us looking over your property at a mutually convenient time.


7. Transfer; Euthanasia. If at any time you determine that you no longer want to, or no longer can, keep the Dog, you agree to return the Dog to Little Buddies so that we can take him/her back to arrange another adoption.. You agree not to abandon, give away, sell, or dispose of the Dog in any way. You agree that you may never surrender the Dog to an animal shelter which euthanizes animals. You agree that you may not euthanize the Dog except in the case of terminal illness, injury or old age accompanied by pain and suffering, and in that case the euthanasia must be performed by a licensed veterinarian in a private clinic or hospital.


8. Lost Dog. You agree to make a serious effort to find the Dog if he/she becomes lost, by immediately; (a) filing lost reports with the local police, animal control authorities, animal shelters, SPCAs and local veterinarians, (b) posting lost dog signs and (c) contacting Little Buddies for additional advice.


9. Breach of Agreement; Liquidated Damages. In the event that you do not comply with the terms of this Agreement, or if the Dog is abused or neglected, one of Little Buddies remedies will be to recover the Dog from you upon demand. Promptly after the demand, Little Buddies will come to your residence, and you must surrender the Dog to Little Buddies immediately. In addition, without waiving any of our rights under this Agreement, if you do not surrender the Dog to Little Buddies, you will owe Little Buddies a payment in the amount of $500.00, agreed between us as just and reasonable liquidated damages to compensate Little Buddies for our costs and expenses in connection with your breach of this Agreement.


10. No Liability. Little Buddies is not liable to you or any other party for any claims, legal actions, injuries, losses, damages, costs, expenses, liabilities, lawsuits or judgments whatsoever in connection with your adoption or ownership of the Dog.


11. Entire Agreement; Modification; Binding Effect. This Agreement is the entire agreement between Little Buddies and you, and supersedes any prior understandings between you and Little Buddies with respect to the subject matter hereof. No modification of this Agreement will be valid unless in writing duly signed by both you and Little Buddies. This Agreement is binding on your and Little Buddies successors, heirs, assigns, executors and personal representatives.




Dated: ________________________________






Signature __________________________________________________________________________


Printed Name ______________________________________________________________________


Street Address ______________________________________________________________________


City ______________________ State ________________________ Zip ________________


Home Phone ________________________ Work Phone _________________________________


E-mail _____________________________ Fax ________________________________________


Signature of Spouse/Partner/Roommate __________________________________________________

Little Buddies


Signature of Representative of Little Buddies _____________________________________________


Printed Name and Title ______________________________________________________________


Address __________________________________________________________________________


City ______________________ State _______________________ Zip ________________


Telephone ________________________________________________________________________


E-mail ___________________________________________________________________________




THIS FORM MUST BE COPIED. One copy goes to the Adopter and one copy stays with Little Buddies.



Thank you for adopting a homeless dog.