Create Account or Log In:
Creating an account or logging in via facebook/email will let you save your application, and allow you to access your pets medical records and other important information after you adopt or foster.
Fill out the form below. Please complete all sections of it.
Spayed or neutered:
Up to date on Rabies Vaccine?
Up to date on Distemper Vaccine (FVRCP)?
Tested NEGATIVE for Feline Leukemia Virus (FeLV) and Feline Immunodeficiency Virus (FIV) in the last 2 years?
Special diet, health problems, needs or restrictions?
Reason for needing to return/rehome/give up?
Is he/she dog friendly?
Is he/she cat friendly?
Is he/she kid friendly?
Is he/she stranger friendly?
Where and when did you get him/her from?
Please tell us a little about his/her habits, personality, likes/dislikes, favorite toy, preferred food...
Physical description: color, coat length, ear tipped...
Any other information you would like to provide:
As the undersigned legal owner(s) of the above-described animal, I relinquish all ownership rights to Animal Safe Haven and Adoptions, Inc. (hereafter “ASHA”), I understand that once the animal is in the possession of ASHA, I have no rights to reclaim the animal. The undersigned represents and warrants to ASHA that he/she desires to surrender to ASHA the above described animal. It is further represented by the undersigned that I am the sole owner(s) or duly authorized agent and representative of this animal, with full power and authority to surrender complete and irrevocable custody, possession, ownership and control of this animal and that no other person or entity has any ownership interest in or authority over this animal whatsoever. The undersigned understands that ASHA will take full responsibility for any future care and placement of this animal and that it is the intention of ASHA to place this animal of adoption in to a suitable home selected by ASHA. The undersigned is informed that ASHA operates largely as a no-kill, and exclusively out of foster families. The undersigned hereby specifically and forever agrees to release and hold harmless ASHA from any and all liability regarding the placement for adoption by ASHA of the above described animal or for any other actions or in-actions taken by ASHA with regard to custody, care and treatment of this animal. The undersigned also fully understands that any intake/surrender donation/fee is completely non-refundable for at any point in time for any reason. This surrender agreement has been entered in to willingly, knowingly, and voluntarily with the understanding that this animal will not be returned to or adopted by the undersigned under any condition. This agreement is not valid unless signed and dated by an authorized representative from ASHA.
By choosing "YES" and submitting this form you are agreeing to the above. This contract is not valid unless viewed, approved, printed and signed by a ASHA representive.
FYI: We are a foster based rescue that works primarly with rescuing cats and kittens off the streets and out of dangerous situations. We RARELY take in owner surrenders. Inorder to take in an owner surrender first we must have room available, the animal must be up to date on core vaccines (rabies & distemper/FVRCP), spayed/neutered and in good health. We can not take on any special health or behavior cases due to our limited resources. In addition owner surrenders also REQUIRE a minimum of a $200 donation for any age and size animal. We always have a waitlist of animals owners want to surrender so the wait time to have us take in your animal could be up to 6 months or longer. We can provide you with a list of local no-kill non-profit rescues, but it's not likely that they will have room. Your best bet would be to make a cute video using photos and videos of the animal and post it to social media and YouTube to gain social exposure in hopes of finding sympathy with the public and finding the animal a home.
By submitting this form I agree that all above info is the truth as I know it and that I am the owner or Co-owner of this animal.