Adoption Application | Reptile Universe

Completing this application does not guarantee an adoption. Our goal is to match our animals with the best family for their specific needs.

Description/Name of reptile:

Primary Adopter

Name:

Phone:

Email:

Employment:

Work Phone:

Occupation:

Time with current employer:

Co-Adopter

Name:

Phone:

Email:

Employment:

Pre-Adoption Questions

Have you had reptiles/amphibians previously?

Yes No Unsure

Where will you primarily keep your reptile/amphibian?

Describe the enclosure (type, dimensions, lighting, etc.):

Additional comments:

Residential Information

Address:

City:

State/Zip:

Do you rent or own your home?

Own Rent Live with parents Other

Other residents besides immediate family?

Yes No

Children

Are there children living in the home?

Yes, full time Yes, part time None

Character References

Name:

Phone Number:

Name:

Phone Number:

Please read and initial each:

I certify that the information provided is true and correct.

I am financially able to care for this animal.

I accept said reptile “as is” per the disclaimer below.

Disclaimer: Reptile Universe LLC (RU) does not guarantee the health, condition, temperament or behavior of the reptile, or that it is free of genetic defects, or other health conditions. The information provided is correct to the best of the RU’s knowledge and understanding.

My signature below acknowledges that I am at least 18 years of age and that I have read and understood this form. I will accept the above-described reptile as part of my family and will care for it throughout its remaining days.

Signature:

Date: