Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone

(###)

###

####

Sex

Male

Female

Spayed or Neutered

Yes

No

I, the undersigned adopter, hereby agree to care for the animal humanely (including providing adequate food, water, shelter, and necessary veterinary care) and license it in accordance with the laws and ordinances of the jurisdiction in which I reside. I also agree not to sell, trade, or dispose of said animal in any way, but to return it to American Wirehaired Pointing Griffon Association (“AWPGA”) at any time I wish to relinquish custody. I further agree that said animal shall not be used for medical or any experimental purposes whatsoever, shall not be kept chained or tied, and shall not be attack-trained, or used for fighting purposes. In addition, I agree that the dog will live in my home with me and not in an outdoor kennel. I will not allow the animal to be free to roam the streets and will not transport it in the back of an open truck except within a dog crate. I further agree to comply with all applicable laws and ordinances related to the ownership or possession of an animal in the jurisdiction in which I reside, including, without limitation, leash laws. *

Confirm

It is understood that a representative of American Wirehaired Pointing Griffon Association may examine and make inquiry about said animal at any time, and if not satisfied with its condition or the conditions in which it is being kept, or if I fail to comply with the terms of this adoption placement contract, said animal may be reclaimed by AWPGA immediately. It is furtherunderstood that no AKC registration is guaranteed in this transaction. *

Confirm

A two-week trial period is provided during which time the animal may be returned by the adopter for any reason and the adopter's fee will be full refunded. *

Confirm

I hereby release and discharge the American Wirehaired Pointing Griffon Association, its directors and the undersigned Placement Officer(s) from any and all actions, causes of action, claims, suits, liabilities, and demands of any nature, at law or in equity, that may be asserted, and hereby agree not to sue any of the AWPGA Board of Directors, Placement Officers or volunteers, for any and all loss, injury, costs, or damages of any nature whatsoever, whether caused by the negligence (or otherwise) of any of the AWPGA directors, Placement Officers, or volunteers, which may be incurred or suffered by me in connection with the placement or possession of the dog, including, without limitation, actions arising out of the conduct, behavior, or disposition of the dog during my possession of it. *

Confirm

I also agree to indemnify and hold harmless AWPGA, its directors, Placement Officers an/or volunteers from and against any and all actions, causes of action, claims, suits, liabilities, demands, damages, costs, expenses, liabilities, obligations, debts, dues, bonds, covenants, contracts, agreements, and judgements that may be asserted against any of the above-mentioned parties, including, without limitation, those brought by any third party on my behalf or on his or her own behalf, arising out of or in anyway relating to, (i) any act or omission committed or omitted by me in connection with this placement or otherwise arising out of the placement of the dog, (ii) my possession of the dog, or (iii) any conduct, behavior, or disposition of the dog during my possession. This release and indemnification shall be binding upon me and my personal representatives and heirs. *

Confirm

I also understand that the AWPGA, directors, Placement Officers, and volunteers will not be responsible for any medical care (or cost thereof) required after placement of the animal. In addition, the AWPGA, its directors, Placement Officers, and volunteers cannot be held responsible for the conduct, behavior, or disposition of this dog after its placement. *

Confirm

Unconfirmed and unverified information has been voluntarily provided to American Wirehaired Pointing Griffon Association by the releasing individual or agency. Additional information with regard to the history or physical condition of the dog is often unavailable; therefore, AWPGA, its directors, Placement Officers, and volunteers make neither warranty nor guaranty, expressed or implied, with regard to the physical condition of the dog, its background, nor its suitability or compatibility. *

Confirm

If the dog is returned for any reason at any time, he/she must be returned to the point of adoption or to a place mutually agreed upon in consultation with an AWPGA director or Placement Officer. The adopter must also provide the means by which the dog is returned and cover any expenses involved in returning the dog unless otherwise discussed at the time of adoption. *

Confirm

I understand that part of the adoption fee may be applied as dues for a one-year single membership in the AWPGA. If I wish to join the AWPGA, I must complete an application on the AWPGA website (www.awpga.com). The Placement Officer listed below may be identified as my sponsor for membership. If I do not elect to join the AWPGA, the part of the adoption fee would have applied to my dues is not refundable. *

Confirm

This placement contract is the entire agreement of the parties with respect to the subject matter contained herein. The internal, substantive laws of the State of Oregon will govern the interpretation and enforcement of this contract, without regard to conflicts of laws principles. If any portion of this placement contract is held invalid by a court of competent jurisdiction, the remainder of the placement contract shall continue in full legal force and effect. *

Confirm

I agree that submitting this form shall be taken as a legal substitute for my signature. *

Confirm

Name *

First Name

Last Name

Date

MM

DD

YYYY