I certify that the information provided on this application is true, and I recognize that any falsification of information requested may result in losing adoption privileges. I authorize investigation of all statements in this application and understand veterinarians, other humane agencies, landlords, or other outside sources may be contacted. I understand that the adoption of an animal may be delayed until such information can be verified. Upon submitting this application, it becomes sole property of the Humane Society of Wickenburg. The information in this document is confidential and will be kept in the strictest confidence.
Humane Society. Of Wickenburg reserves the right to deny adoption or fostering of animals to anyone based upon this application and/or investigation of additional information for any reason. I understand that Humane Society of Wickenburg makes decisions in the best interest of the animal. As a Humane Society of Wickenburg adoption applicant, I understand that I will be interacting with and handling animals. I understand that in handling animals I may undertake any number of risks. I understand that in assuming this I may be exposing myself to potentially significant health risks or serious medical conditions, including, but not limited to: injuries from bites and scratches, slips or falls, infectious diseases, parasites, and allergic reactions (e.g. rabies, fleas, ringworm, allergies, and asthma). Since many animals that come to the SHHS are from unknown backgrounds and are therefore ultimately unpredictable, I am thus aware that Humane Society of Wickenburg is not in a position to know and makes no representations with the temperament, health or condition of any animal in particular. I must rely on my own judgment and I understand and agree that by handling the animal, as an applicant I do so at my own risk. Therefore, I agree to hold harmless, the SHHS, its employees, volunteers, agents, or directors, whether collectively or individually, for any injury or liability the animal(s) may cause to me. I further assume any and all liability for damages or to other persons, which may be caused by any animal(s) while in my care as an applicant, and hold the Humane Society of Wickenburg harmless therefrom.