For Prospective New Homes – Agreement Form

The Clumber Spaniel Club of America’s Rescue & Placement Committee makes every effort in its rescue placements to ensure the most careful, compatible adoptions possible. Considerable involvement, time and energy go into making certain that each dog is appropriately placed in qualified, loving homes.

Please carefully read and sign the following agreement as part of our rescue procedure:

1.All of the information I/We (henceforth “I” to be considered as both an individual, couple or family) have provided on the Rescue & Placement Questionnaire is true and complete to the best of my knowledge. I have not withheld or altered necessary information in order to solicit approval for future adoption.

2.Should an unneutered or unspayed Clumber be placed with me, I agree to have it neutered or spayed within 30 days of receipt of this dog or by a date agreed on by me and a Rescue & Placement Committee representative. I agree not to breed this Clumber or allow any outside party to under any circumstances.

3.I agree not to sell, trade, transfer ownership, abandon or dispose of this dog in any way. If I am unable to keep this Clumber, I will notify Clumber Rescue & Placement. I will surrender ownership of this Clumber to them. Only their committee will be responsible for its subsequent placement.

4.I will keep this Clumber as my companion/pet only and will provide proper shelter, protection and control. I agree to provide whatever veterinary care and treatment is needed in addition to regular vaccinations, as well as heartworm and flea and tick control. This Clumber will be properly supervised on a regular basis.

5.I will assume full and complete responsibility for this dog’s actions and for any damage and/or injury resulting from its actions.

6.On delivery and/or receipt of this Clumber, I will assume full ownership of the dog, with all of its inherent rights, responsibilities and liabilities. Concurrently, the previous owners must relinquish all corresponding rights and obligations in said Clumber.

  1. The Clumber Spaniel Club of America, its Board of Directors, Committees and The Clumber Spaniel Rescue Charitable Trust, CSCA Rescue & Placement, and CSCA members are not liable or responsible for any accident, damage, injury or legal action that may result from the placement of this Clumber in my household. I hereby forever release, discharge, agree to hold harmless, and indemnify the above principals or their agents from all claims, demands, actions, causes of action, or liability of any kind whatsoever arising as a result of or in connection with the placement of a Clumber Spaniel into my home. The history and information I have received about this dog is as accurate and complete as possible.
  1. The Clumber Spaniel Club of America’s Rescue & Placement Committee operated in good faith and is not responsible for any omission or distortion of history from the dog’s previous owner.

The undersigned hereby agrees to abide by all the conditions and responsibilities set forth above.

Signed: ______Date: ______ (Owner/Co-Owner)

The CSCA Rescue & Placement Committee member:

Signature On Receipt: ______Date: ______