Puppy Reservation Form

Buyer's Name:__________________________________________________________________________________________

E-Mail Address:_________________________________________________________________________________________


City:_____________________________________State:_________________________Zip Code:________________________

Home Phone#:_____________________________________Cell Phone#:___________________________________________

Litter Sire:_________________________________________Litter Dam:____________________________________________

                                                  Companion:__________  Show:__________   Field:__________

A deposit in the amount of $300.00 is required to reserve a puppy.  The deposit must be received promptly (within 5 business days) in order to reserve a puppy.  The pick of a puppy from a particular litter is given in the order in which the reservations are received.

Puppies are picked when they are 6 weeks old and go home at 8 weeks old.  This allows puppies to develop markings/coloration and start to develop their personality. 

The reservation signifies that the Buyer intends to follow through with the purchase of the puppy from the Seller.  In the event the Buyer cannot follow through with the purchase of the puppy, the reservation is forfeited and NO refund will be given.  The best policy is to be absolutely certain that you want this particular puppy or pick in a litter before sending your reservation.

Personal checks are accepted for reservations only.  The outstanding balance shall be paid to and received by the Seller prior to the Buyer taking possession of the puppy.  The balance must be paid in cash when the puppy is picked up. 

If by tragic accident the puppy dies or is determined to have a congenital defect that prevents the puppy from being a companion animal, a full refund of deposit will be given to the Buyer.  If there is another puppy available, the Buyer may designate their reservation be put towards that puppy.  The Seller reserves the right to refund the deposit even if another puppy is available.  The Seller reserves the right to void this transaction and refund the deposit if we feel the Buyer might not be suitable for the puppy.  Refleksion Kennel may take up to 30 days to return or refund your reservation.

By signing below, the Buyer confirms agreement to the terms and guidelines outlined above.


________________________________________________________     ______________________________________________________

Buyer's Printed Name                                                                                    Buyer's Signature




Please make checks payable to and mail to:

     Anne Cohen

     39 Wynell Rd.

     Perkinston,  MS  39573-5051