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Signature Date By signing this, I agree that at the time of adoption the animal above appeared healthy and that Pickens County makes no guarantee about the future health of the animal, and any medical costs related to this animal become my responsibility. It is understood that the animal’s known medical status and known temperament have been discussed at the time of adoption. This animal may have been previously exposed to viruses and/or diseases that the Pickens County Animal Shelter would have no reasonable way of identifying. It is my responsibility as this pet’s new owner to assume any additional veterinary costs. By signing below, I assume the risk of adopting this animal and expressly waive any and all claims against Pickens County, Pickens County Animal Shelter, or its agents, now or in the future for any and all personal or property damage and injury related to this animal. In accordance with the Ordinances of Pickens County, I agree to provide my pet with quality care which includes, but is not limited to, healthy food, clean water, adequate space, dry shelter, sanitary conditions, and necessary veterinary care, including an annual rabies vaccination (the annual rabies vaccination is also required by Georgia State Law). I will not permit my companion animal to run loose and will keep identification tags on the animal at all times. If my companion animal should become lost, I will make every reasonable effort to relocate and claim the animal. As a responsible pet owner, I promise to abide by the Ordinances of Pickens County pertaining to owning a pet. (Find the Ordinances at www.pickenscountyga.gov. Click on Resources - Code of Ordinances, search or scroll down to Chapter 14: Animals.) Adoption fees are not refundable. If at any time, I am unable to continue to provide adequate care for this animal, I agree to contact the Pickens County Animal Shelter and give them the option of reclaiming the animal. However, I understand that there is a fee of $25.00 to surrender this animal to the shelter. Pickens County Animal Shelter Adoption Contract Name Date Address City State Zip Phone Number Email Name of Vet Phone Number Do you Own or Rent? If Rent, are pets allowed? Other Pets Fenced Yard? Name of Animal Adopting 3563 Camp Road, Jasper, GA 30143 [PHONE REDACTED] [EMAIL REDACTED]