Fields marked with a * are required
Date of Birth
District of Columbia
Zip / Post Code
*Please make sure your email address, phone number, and address are entered correctly and in their entirety, so that we are able to contact you as soon as possible. Thank You!
Do you live in a house, apartment, condo, or other?
Do you own or rent your home? If you rent, please provide your landlord's contact information.
How long have you lived at your current address?
Are you currently employed?
If so, please provide employer's name.
How long have you been with this employer?
Please list the name, age, and relationship of those persons residing with you.
How busy is your household? Are there people visiting regularly, every so often, or not often? Please explain.
Do you have nieces, nephews, grandchildren, neighborhood kids, etc. who visit your home often? Please explain.
What animals are currently living in your home? What are their ages, temperaments, and reactions to dogs, if known?
Please list all the animals you have owned in the last 5 years? Please include their name, species, breed, age, spayed or neutered, temperament, if you still own them and, if not, what happened to them. You do not need to include the animals listed above.
Which veterinarian do you use? Please provide his or her contact information.
May we contact your veterinarian?
Have you ever rescued a dog before?
Have you ever sold, given away, or surrendered an animal to a shelter? If so, please explain.
Is there any reason you would give up your dog?
What kind(s) of previous dog experience do you have, i.e. training, activities, etc.?
If applying to adopt a puppy, have you ever owned a puppy before or been involved in puppy training? Please explain.
Are you willing to work with a trainer if any behavioral problems arise with your new dog? If so, how much are you willing or able to spend on training?
Do you have a yard? If so, is it fenced? What type/kind and its height?
How to you plan to accommodate your new dog's exercise needs?
How many hours will your new dog be left alone during the day?
Where will your new dog stay when left alone?
Where will your new dog sleep at night?
Describe a normal day for your household during the work week and on the weekend.
Have there been any recent major changes in your household?
Is there anything else you would like us to know about you or your family?
Which dog/puppy are you interested in adopting? If there is no specific dog, what are the personality traits and the activity level you are looking for in a new dog?
Please provide two references, one of them being a neighbor.
GENERAL RELEASE OF LIABILITY, WAIVER OF CLAIMS, EXPRESS ASSUMPTION OF RISKS, AND HOLD HARMLESS AGREEMENT
You, as the Applicant to adopt a dog (the “Applicant”) through Colorado Canine Rescue (“CCR”), and your estate, heirs, administrators, executors, and assigns, hereby release, forever discharge and hold harmless CCR, including but not limited to its board of directors, its employees, its representatives, its agents and its volunteers and their heirs (collectively called the “Released Parties”) from any and all liability and responsibility whatsoever, however caused, for any and all damages, claims, demands, or causes of action that you, your estate, your heirs, your administrators, executors, or assigns may have for any loss, illness, personal injury, death, or property damage arising out of, connected with, or in any manner pertaining to the Application process or any visitation whether caused by negligence of the Released Parties’, accident, deliberate act, omissions, or otherwise.
You, the Applicant, understand and acknowledge the fact that canines can be unpredictable and CCR is not responsible if injury should occur to you, any members of your family, or any third parties resulting from the canines fostered or adopted through the CCR program.
In signing this agreement, you, the Applicant, acknowledge and represent that you have read and understand this agreement; that you sign this agreement voluntarily; no oral representations, statements, or inducements have been made; you are at least eighteen years of age and fully competent; you understand that you are giving up substantial rights by signing this agreement; and you voluntarily agree to be bound by this agreement.
Once the application has been successfully submitted, you will be redirected to a "Successful Submission" page and you will also receive a confirmation e-mail.