Animals for Adoption

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Harmony Animal Rescue & Rehab, Saybrook, CT               Date:   /   /    

Transfer of Care Form 

(Rehome Agreement) 

Small animal adoption application 

Applicant name:___________________________ 


How many people in home______ 

How many other pets in home_______ breeds___________________________________ 


Why did you want to adopt? _____________________________________________________________ 







I,___________________________ [______________________________(print)], Agree to the following terms and conditions and am signing this, being of clear mind. 

I am willingly taking this animal under my care, and am forfeiting the right to make claims against Harmony Animal Rescue, should unforeseen something happen. 

Harmony Animal Rescue, it's staff, and owner are not to be held responsible should something occur. 

I assure that I have the time and correct information to properly care for this animal (and/or its release {for wildlife}) 

I accept that if an injury* to me, my children, other people in my life, my pets, or my property occurs, I am to be fully responsible, and not Harmony Animal Rescue.   

Harmony Animal Rescue reserves the right to perform a 3-month and/or 6-month in-home visit/inspection, and regain ownership of the animal if conditions are decidedly sub-standard for the health/well-being of that animal.                                                                                                                                                 

                  *'Injury' refers to any scratch, bite, bruise, pressure-injury, allergy, intoxication, (or in the case of certain species, poisoning) 

    Executor For Harmony,____________________________ 


             (witness, if applicable:________________________) 


Harmony Animal Rescue & Rehab Old Saybrook, CT 06475    Tel. -__________________________