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Basenji Rescue
and Transport |
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Basenji Rescue and Transport, Inc.
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| For official use only. Basenji Name:__________________________________Age:________ I.D. Type/No.:______________________________________________ Color: ( ) Red/White ( ) Black/White ( ) Tri-Color ( ) Brindle Sex: ( ) Male ( ) Female Basenji Rescue And Transport, Inc., a Texas non-profit corporation (BRAT), has established this Contract to detail the specific requirements to which the Transferor must comply as a condition of the Adoption/Transfer of the pet Basenji whose name and description appear above. TRANSFER Transferor represents that he/she is the only owner of the Basenji herein described ("the Basenji"), and hereby transfers all of his/her ownership right, title and interest in said animal to Basenji Rescue And Transport, Inc. (BRAT). Transferor represents that the Basenji has never caused or been alleged to cause injury to a person except as follows: Transferor appoints BRAT as its agent, with all rights and privileges thereof, to attempt to place this Basenji in a new home on behalf of Transferor. BRAT will use its best efforts to place said Basenji in a new home pursuant to the requirements as stipulated in the Adoption Contract, including mandatory neutering. However, Transferor understands and acknowledges that BRAT may not be able to place the Basenji and that this transfer is without any recourse. All adoption fees for the Basenji will be paid directly to BRAT and Transferor will not be entitled to any portion of such fees. Transferor releases and agree to hold harmless BRAT from all claims or causes of action regarding this transfer of ownership, including any claims by a third party to ownership of the dog. Veterinarian Records and AKC records must be turned over to BRAT at time of surrender, for verification of ownership, vaccinations and heartworm prevention. I certify that all representations contained herein are true and correct and that I have read, understand and agree to the stipulations contained in this Contract. Signed by Transferor:______________________on this day of:______________ Printed Name:_____________________________________________________ Address:_________________________________________________________ City:______________________________ State:________ Zip Code:_________ Phone Numbers: (H) (___)______________(W) (___)______________ Agent's Name(s):___________________________________________ Phone Number: (___)__________________ BASENJI RESCUE AND TRANSPORT, INC. By: __________________________________ Printed Name: ____________________________________________ Its: __________________________________ After this Contract has been executed, both the Transferor and the BRAT Representative should keep a copy for their records and return the original to: Elizabeth Newton E-mail: Adoption@basenjirescue.org Revised May 25 2005 |