MGPR Application Forms
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Dog Adoption Application
Fostering Application
Cat Adoption Application
Dog Adoption Application
Anything with
*
are required questions and must be filled in. If you miss a question, the form will not submit and the missing answer will be highlighted in red. Simply fill in the missing answer and click SUBMIT again.
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Indicates required field
Name of DOG applying to adopt:
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Name
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First
Last
Home Phone Number
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Cell Number
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Email
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Full Address
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Please include street, number, city, province and postal code.
Are you employed?
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Yes, full time.
Yes, part time.
No.
Are you 18 years of age or older?
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Yes
No
Do you currently rent or own your home?
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I rent my home.
I own my home.
If you rent, do we have permission to contact your landlord?
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Yes
No
Landlord contact information:
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Phone number, e-mail address or street address required.
How many adults (18+ years) in the home?
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1
2
3
4
5
6+
How many children (less than 18 years of age) in the home?
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0
1
2
3
4
5
6+
If there are children, how old are they?
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Does anyone in the home have pet allergies?
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Yes
No
Do you have other pets at the current time?
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Yes
No
If yes, how many and what kind?
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Are your current pets spayed/neutered?
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Yes
No
Are your current pets up to date on all their shots?
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Yes
No
If adopted, would the dog be an indoor or outdoor dog?
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Indoor dog.
Outdoor dog.
Both indoor and outdoor.
On an average day, how long would the dog be left alone?
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0-2 hours
3-5 hours
6-8 hours
8+ hours
Where would the dog spend most of the day?
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Loose in House
Kennel/Crate in House
Confined to area of house
Dog Run
Backyard
Outdoor Kennel/Run
Doggy Daycare
With friend/relative
Other (Explain in the comment box at the end)
Where would the dog spend most of the night?
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Loose in the house
Kennel/Crate in house
Confined in area of the house
Backyard
Outdoor Kennel/Run
Other (Explain in comment box at the end)
Do you have a fully fenced yard?
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Yes
No
If yes, how high?
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How do you plan to exercise your dog?
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What do you plan to do with the dog when you go on vacation?
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Boarding Kennel
Family or friend will dog sit at my home
Family or friend will dog sit at their house
Take the dog with us
Other (that I will explain in the comment box at the end)
Showing
What is your reason for obtaining a dog? (Pick all the apply.)
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Guard Dog
Working Dog
Companionship
Children's Pet
Gift
Animal's Companion
Showing
Other (Explain in the comment box at end)
Have you ever previously applied to adopt a dog?
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Yes
No
If yes, from where?
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Was your adoption approved?
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Have your ever given away a previously owned pet?
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Yes
No
If so, please explain why.
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Will the dog remain a member of your family if a new baby is added to your family?
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Yes
No
Maybe
If any member of your family develops allergies, would you be willing to try different methods to reduce or eliminate the allergies or would you return the dog immediately to MGPR?
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Yes, we would try different methods.
No, we would return the dog to MGPR.
If you have to move to a new house, in a new city or possibly even a new country, would the dog remain a member of your family or would you immediately return the dog to MGPR?
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The dog would remain as part of the family.
We would return the dog to MGPR.
Reference #1
Reference Name
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First
Last
Relationship to you
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Reference Phone Number
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Reference #2
Reference Name
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First
Last
Relationship to you
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Reference Phone Number
*
Other information that may be of interest
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Veterinary Information Release Form
I, the undersigned, authorize the veterinary clinic outlined below, to release any and all information and knowledge they have regarding my past care of animals in my possession to MGPR. MGPR in turn agrees to keep all such information obtained confidential and to use the information solely for the purpose of determining suitability of the individual as an adopter of one of our rescued dogs. Any information obtained will not be released to other parties unless the individual authorizing the release gives us written consent.
Veterinarian's Name & Animal Clinic name
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Both the Vet's name and Animal Clinic's names are required for contact purposes.
Veterinarian's Phone Number
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Manitobe Great Pyrenees Rescue
Adoption Agreement
If for any reason you are unable to keep the dog in the future
the dog must be returned to MGPR for re-adoption
as opposed to being turned over to the pound, another rescue, sold, euthanized or re-homed through a classified ad.
MGPR reserves the right to repossess any adopted dog in the event that the rescue has reasons to believe the dog is being mistreated, or if information supplied on this form is discovered untruthful.
In signing below you are agreeing to the terms as outlined above. If the terms are not met, you the undersigned will be liable and legal action may be taken.
The following document outlines the terms of agreement when adopting a dog through MGPR. These terms provide the requirements of owning an MGPR dog.
ADOPTION
Please note that MGPR reserves the right to refuse adoption for any reason. Homes are selected based on the individual needs of the dog available for adoption, and homes for special needs dogs may be subject to an individualized adoption process.
Adoption fees will be returned minus a $25 administrative fee for any dog brought back into rescue within 14 days of adoption.
All
dogs, without exception must be returned to MGPR if the adoptive family is no longer interested in keeping the dog, regardless of the amount of time that has passed or legal action may be taken.
If the adoptive family has located new potential owners, they may not place the dog without written consent from a director of MGPR. Although MGPR will take into consideration the family’s wishes with regard to placement of the dog, MGPR has the final decision. The new family must meet the adoption criteria and a new adoption agreement must be signed
.
If the dog has been placed without consent from MGPR, the rescue reserves the right to re-possess the dog. Adopted dogs may not be surrendered to the pound, or any other rescue or animal facility. If an adopted dog is discovered in a rescue or other facility, any expenses incurred to return the dog back into the care of MGPR will be billed to the adoptive family on file with MGPR accordingly.
If it is discovered that any dog adopted from MGPR is being kept in neglectful conditions as determined by the Manitoba Animal Care Act, MGPR reserves the right to re-possess said dog at that time with no return of the adoption fee. This situation may or may not be discussed with the adoptive family prior to the seizure dependant on the condition of the adoptive pet. This also includes methods of training deemed cruel or inhumane by MGPR.
No MGPR dog may be kept outside on a permanent basis. All MGPR dogs are to be kept as house pets, unless otherwise specified by MGPR.
ADOPTION FEES
Adoption fees charged are at the discretion of MGPR.
Adoption fees are set out at $395 for puppies (under 6 months) and $345 for dogs (6 months +), unless otherwise agreed upon in writing by MGPR. All dog adoption fees include 3 Parvo/Distemper vaccines, rabies vaccines, deworming, microchip, tattoo, plus spay/neuter, Heartworm/Lyme disease tests when applicable, as well as other vet procedures as deemed necessary to ensure a healthy dog. If there are known health issues that have not been treated, MGPR will ensure potential adopters are aware of these and the choice to adopt is left to the adopter. These health issues may have been untreated for a variety of reasons including old age or the rescue was unable to afford the treatment. In all cases, dogs are treated for all illnesses that affect quality of life.
Fees are set accordingly in order to cover basic vetting. Any overages from adoption fees will go toward vet fees and costs incurred rescuing other dogs whose adoption fees do NOT cover their required vetting.
SPAYING AND NEUTERING
All dogs adopted through MGPR are required to be spayed or neutered at the age of six months unless otherwise specified. Puppies are scheduled for spaying or neutering by MGPR. The adoptive families are made aware of the spaying and neutering appointments and are required to bring their dog to those appointments. Failure to do so may result in the dog being repossessed by MGPR.
Adoption fees will
not
be returned if an unaltered dog is re-possessed by the MGPR.
HEALTH CONCERNS
All dogs adopted through MGPR are subject to vetting prior to adoption. In the event that any concerns arise with regards to the health of the adopted dog within 30 days of adoption, MGPR will provide assistance with vetting costs within the financial abilities of the rescue. In the event an adopted dog is found to be ill beyond the financial means of the rescue, the adoptive family may choose to manage the expenses or the dog may be surrendered back to the rescue with full adoption fees returned. Any vetting costs that result beyond 30 days of adoption will be the full responsibility of the adoptive family. This is of course null and void if the health issue is due directly to a cause that should have been prevented by the adoptive family or to external circumstances outside the rescue’s or adoptive home’s control. I.e. if the dog gets loose and is struck by a car, MGPR bears no responsibility ; if the dog is allowed to consume a poisonous substance, again, MGPR bears no responsibility as this was within the control of the adoptive family.
***ALL DOGS MUST BE PUT ON HEARTWORM PREVENTATIVE FROM JUNE UNTIL NOVEMBER. This is non-negotiable. Heartworm is a very real and very prevalent problem in Manitoba. It is a preventable illness. MGPR reserves the right to contact veterinary clinics to ensure all adopted dogs are on heartworm preventative. ***
LEGAL OBLIGATIONS
MGPR can not be held responsible for any damages that occur in adoptive homes, and is not liable for direct, indirect, incidental, special, or consequential damages arising out of, or relating to dogs adopted through MGPR, whether framed as a breach of warranty, upon any legal theory, in tort, contract, failure of essential purpose, or otherwise. MGPR makes no warranty, express or implied regarding any of the dogs in our rescue. Adoptive families are obligated to report any concerns to the rescue, and any dog adopted through MGPR will be accepted back into our rescue in the event they are not working out in their adoptive home.
All dogs adopted from MGPR within the city of Winnipeg must be licensed with the City of Winnipeg Animal Services.
PRIVACY POLICY
Throughout your dealings with MGPR, information provided on your adoption form will be kept on record, for our adoption files. This information will not be used in any solicitation and will not be provided to any organization exterior to MGPR.
The terms and agreements outlined in this document are legally binding. I, agree that I am aware of the terms of agreement outlined in this three page document, and by providing my signature below I acknowledge that I have read and agree to the terms as outlined by MGPR. My digital signature also provides verification that I have received a copy of these terms of agreement for my own records.
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I agree to the above terms & conditions.
Digital Signature (type your name)
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Date
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