| Lhasa Apso Rescue - Liability Release [THESE FORMS ARE DESIGNED TO PROTECT THE ADOPTIVE DOG FROM EVER BEING HOMELESS OR MISTREATED OR PUT IN JEOPARDY IN ANY WAY. WE HOPE YOU AGREE THAT THIS IS IN THE BEST INTEREST OF THE DOG.] If there is not a representative listed for your region or state, contact one of the following people for assistance, assuming you haven't been contacted after 2 weeks from submission of your electronic Application: Debbie at: (919) 870-6774, daleach@worldnet.att.net Vickie at: (970) 663-5910, ApsoRescue@aol.com Brian at: (909) 621-7371, or cell at (909) 772-0936, lannanarms@msn.com Barbara at: heidideidi@access4less.net Because we depend soley on volunteers and we do not have coverage in all areas of the country, it is possible that your adoption process and approval may be delayed or even be geographically impossible. The more active volunteers we have, the more efficient our ability to respond to the needs of the dogs and the adopters will be. Please consider volunteering. Thank you for your patience and understanding throughout the process! The Contract & Liability Release forms cannot be Emailed, they will be picked up by the representative conducting the home visit. Applications are submitted electronically. AMERICAN LHASA APSO CLUB RESCUE RELEASE OF LIABILITY AND INDEMNIFICATION In consideration of the AMERICAN LHASA APSO CLUB RESCUE allowing me/us to adopt this Lhasa as my pet, I/we agree to be solely responsible for this animal and to indemnify and hold harmless the AMERICAN LHASA APSO CLUB RESCUE and its board of directors, members, officers, and agents from any and all claims of liability by myself/ourselves or third parties for the conduct of this Lhasa on or after the date of this adoption. The undersigned further agree[s] and intend[s] that this RELEASE OF LIABILITY AND INDEMNIFICATION shall apply to any damages resulting from my/our adoption, ownership, or control of such animal. This document incorporates all the information provided in the Adoption Application & Contract. I/We have read the foregoing and agree with all provisions and stipulations stated herein. THIS IS A BINDING CONTRACT, ENFORCEABLE BY CIVIL LAW. If the above statements are found to be fraudulent or untrue, we reserve the right to repossess the dog and all liabilities are waived. SIGNATURE (Must be signed by all adults in household responsible for this Lhasa) Name (Print)____________________________________________ Date____/____/____ Name (Print)____________________________________________ Date____/____/____ Signature______________________________________________ Signature______________________________________________ Address___________________________________________________ City__________________________ State/Canadian Province______________________ Zip__________ Phone (home)______________________________ Phone (work)_____________________________ext____ Phone (home)______________________________ Phone (work)_____________________________ext____ Driver's License #________________________________ License Plate#_____________________________ Driver's License #________________________________ License Plate #_____________________________ Agent, AMERICAN LHASA APSO CLUB RESCUE _______________________________________________ Date____/____/____ Finally the Application |