MIDLAND COUNTY PIT STOP
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    Midland County Pit Stop Pet Adoption Application

    FOR OFFICE USE ONLY
    Payment Date                                                               
    Payment Amount                                                        
    Form of Payment                                                        
          **Additional fee for debit/credit card payment**

    Adoption Applicant Information

    References

    Please provide three references who are not considered family or living with you.

    Current/Previous Pet Info

    Home/Family Information

    Check all that apply

    Care Plan

    Veterinary Care

    Tell us about your experience with pets


     ​​**If for any reason you are unable to care for or keep the adopted animal, contact Midland County Pit Stop. **
    PERSONAL OR PROPERTY DAMAGE AND/OR INJURY
    I acknowledge and agree that if the adopted animal bites or causes other injuries to humans and other animal, I will not hold Midland County Pit Stop of Midland Michigan responsible. I understand that all animals can carry and transmit diseases, including zoonotic diseases that can be transferred from animals to humans. I understand that Midland County Pit Stop will not be responsible for any damage the adopted animal may inflict on another person, another animal or any property, or for the transmission or transfer of any disease or parasite to other animals or people in the household.  No attempt(s) will be made by me or anyone on my behalf to hold Midland County Pit Stop responsible. I hereby release Midland County Pit Stop and its agents, representatives/liaisons, and volunteers, and agree to indemnify and hold same harmless from any and all actions, causes of action, suits, debts, dues, accounts, covenants, agreements, judgements, claims and demand of any nature whatsoever arising out of my adoption of a pet from Midland County Pit Stop..

    I understand that if I am approved as an adoptee to a pet, I must abide by this agreement and that this agreement applies to any and all dogs/cats that I adopt from Midland County Pit Stop.

    **Adoption fees are non-refundable**

    **Signature will be required upon approval of Application
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  • Home
  • About
  • Adopt Me!
    • K-9
    • Feline
  • Forms
    • I Want to Adopt
    • I Want to Foster
    • Surrender My Pet
    • Find a Foster for My Pet
    • I Want to Help!
  • Donate
  • CommUnity
  • Event Calendar
  • Contact