Dog Adoption Form · MAXI 2609

Application date: 10/11/2026. Your application reference is assigned after submission.

Adopter details

Full name * CPR or passport number * Nationality * Mobile or WhatsApp number * Email address * Emergency contact name * Emergency contact phone * Residential address including house or flat, road, block and area *

Home and care

Home * Occupancy * Household agrees * Landlord permission * Children at home * Dog ownership experience * Time the dog will spend alone each day * Able to meet ongoing care costs * Care during travel *

Other pets *

DogsCatsOtherNone

Current pets / details Previous dog ownership experience Reason for adoption * Other details or care arrangements Additional information

Dog details

Dog name: MAXI 2609
Public code: BH-ANM-000052
Breed: SHIH TZU
Sex: Female
Age: 01/10/2022
Colour: LIGHT BROWN
Microchip: 991003003535495
Neutered / spayed: Yes

The project representative will confirm identity, vaccination documents, known medical or behavioural needs and handover conditions.

Adoption Agreement

Adopter commitments

I accept responsibility for the dog’s daily care and will provide suitable food, clean water, secure shelter, protection from heat, exercise and humane handling.

I will arrange necessary veterinary treatment, vaccinations and parasite prevention, maintain identification records, and complete any agreed sterilization plan.

I will prevent escape, use safe restraint in public, supervise children and other pets, and arrange proper care during travel.

I will not abuse, neglect, breed, sell or use the dog for fighting. I will not transfer the dog to another person without prior written approval from the project.

I will report a missing dog as soon as I discover the loss, keep my contact details current, and cooperate with reasonable welfare follow ups. Home visits require consent or lawful authority.

If I cannot keep the dog, I will contact DogRescue Bahrain and arrange an approved return or transfer. I will keep the dog safe until the handover is completed. If safe care cannot continue, I will urgently contact the project and competent authority.

No abandonment and consequences

I must never release or leave this dog on the street, in the desert, at the shelter gate or in any public place. Abandonment is punishable under Bahrain Law No. 52 of 2014.

I specifically accept the no abandonment and return conditions, and understand the consequences above.

I have read and accept the adopter commitments and the no abandonment and return conditions above.

Declaration

I confirm that the information provided is accurate, that I am legally able to enter this agreement, and that I have read and accepted its conditions. Known health and behaviour needs have been explained to me. I understand that past history may be incomplete and future health or behaviour cannot be guaranteed.

My information will be used for adoption assessment, records and welfare follow ups, and shared only where necessary and lawful with veterinary providers or competent authorities. Public use of my details requires separate permission.

Print the completed application and sign by hand.

Adopter signature

Project representative signature

Date *