Your name:
Your email address:
Your phone number:
Alt. phone number:
Your address
City / State / Zip Code
Your employer
Do you have a Vet?
If yes, Name & Phone
FAMILY INFORMATION
How many children at home?
Ages of all children listed
Do you own or rent?
Does your home have a yard? Yes/No
If yes, describe type of fence.
Do you have other pets? How many,
what kind?
Who will be responsible for your pet?
Name/ID of Pet you're interested in Adopting
DISCLAIMER
Although our dogs are behavior tested and we work hard to ensure that our dogs are well adjusted and
non-aggressive we cannot guarantee the personality of any dog. KAZ's Corner Pet Rescue, Inc., releases all
legal responsibility of any of our dogs to the new owners.
By clicking "Submit Form" below you hereby agree to and fully understand the disclaimer above.
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