First Name
Last Name
Address Line 1
Address Line 2
City
State
ZIP Code
Phone
Email
Name of your nearest airport
Where will your puppy be kept during the day & at night?
How many hours will your Vintage Golden retrievers spend alone without companionship?
Are you interested in a specific puppy/litter?
Select
Brittini - Female - 10 Weeks Old
Becca - Male - 10 Weeks Old
Brinlee - Male - 10 Weeks Old
Moe - Male - 10 Weeks Old
Blessing - Female - 10 Weeks Old
Nellie - Female - 10 Weeks Old
Nessa - Female - 10 Weeks Old
Newton - Male - 10 Weeks Old
Please select your top 3 color preferences
Select an option
Black,
White,
Black & Tan,
Black & Silver,
Red & Black,
Sable,
Grey
Any Color
Other Color
N/A
(required)
Select an option
Black,
White,
Black & Tan,
Black & Silver,
Red & Black,
Sable,
Grey
Any Color
Other Color
N/A
(required)
Select an option
Black,
White,
Black & Tan,
Black & Silver,
Red & Black,
Sable,
Grey
Any Color
Other Color
N/A
What timeframe are you looking add a puppy to your family?
Select
I’m ready to buy
Not yet ready to buy
When your puppy is ready to join your family, will you need delivery or do you plan to pickup?
Select an option
Pickup ( $400 Reservation Deposit is needed)
Delivery ( $200 additional as shipping fee)
What temperament are you looking for in a puppy?
Select
1. Gentle
2. Friendly
3. Intelligent
4. Affectionate
5. Loyal
6. Playful
7. Protective
8. Easygoing
Do you have any additional information about yourself and your family that will help us consider you for one of our puppies?
How did you hear about us?
Select an option
Online Search
AKC Website
Puppies.com
Google Ad
Facebook
Instagram
Referral
Do you have additional questions?
By submitting this form, I hereby authorize the Doctor of Veterinary Medicine, named above, to disclose and/or release to Vintage Golden retrievers Kennel, it's agents, successors or assigns, either verbally or in writing, complete information concerning his or her medical findings, treatments and records about any animals for which I have sought care and/or treatment from the so named Doctor of Veterinary Medicine. (***Please contact your vet to let them know we will be calling. They may require your permission before speaking with us. ***)
PLEASE NOTE: Your application cannot be processed without acceptance of this waiver.
I/We have voluntarily contacted Vintage Golden retrievers Kennel and have expressed an interest in adopting a dog in the care and custody of Vintage Golden retrievers In consideration of Vintage Golden retrieversKennel's agreement to allow me to view and/or interact with such dogs, I hereby, for myself, my heirs and my personal representatives, represent and warrant as follows:
1. I am fully aware of the risks that dogs pose and have elected to view and/or interact with one or more dogs in the care of Vintage Golden retrievers voluntarily. I knowingly assume all risks that exposure to dogs may pose, including but not limited to, serious bodily injury and/or death.
2. I hereby waive, release, discharge, hold harmless, and promise to indemnify and not to bring suit against Vintage Golden retrievers its directors, officers, volunteers, staff, and all other agents, and attorneys for any of the referenced parties, and any other parties acting for, or on behalf of any of the referenced parties, from any and all rights and claims which I have or which may hereafter accrue to me and from any and all damages which may be sustained by me directly or indirectly in connection with, or arising out of, my exposure to such dogs.
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