Terry, Candy and Jonathan Smith

479 E. Cherry Rd.

Quakertown, PA 18951

(215) 538-2179



Agreement between Rescue and new dog owner.





Name _______________________________________________________________________



Address _____________________________________________________________________



Phone # _____________________________________________________________________



Email ________________________________________________________________________



Both parties agree that the follow amount of ______ is considered a donation to Willow Spring Dog Rescue

and that no guarantee as to the health and temperament can be made by the rescue. Dog may be returned

for refund of donation within 5 days of taking the dog home for any reason. No other guarantee is in place.

Dog is adopted as is, no information other than that found first hand by rescue is provided. Dog may be

returned to rescue, no questions asked at any time during the dog's life. No reimbursement for any vet. fees

incurred after adoption.



Rescue Signature _____________________________________  Date _____________________



New Owner Signature _________________________________  Date _____________________