DRRU - Dog Surrender Form

By signing this form, I state that I am the owner/caregiver of the dog(s) who is/are the subject of the 'Dog Surrender Form', herinafter referred to as "the dog". To my knowledge, no other person(s) has any right to this dog(s). I hereby surrender all rights to this dog(s). I understand that once I relinquish the dog(s), the dog(s) will not be available to be returned. I also understand that if I give the dog(s) away or do not release the dog(s) to the rescue, I will be responsible for reimbursing the rescue.

By signing this form, I state that I am the owner/caregiver of the dog(s) who is/are the subject of the 'Dog Surrender Form', herinafter referred to as "the dog". To my knowledge, no other person(s) has any right to this dog(s). I hereby surrender all rights to this dog(s). I understand that once I relinquish the dog(s), the dog(s) will not be available to be returned. I also understand that if I give the dog(s) away or do not release the dog(s) to the rescue, I will be responsible for reimbursing the rescue. Yes, I have read and agree to the terms above and expenses listed below. No, I do not agree to the terms above or expenses below.
I will/may be responsible for some or all of these expenses as stated above:

I will/may be responsible for some or all of these expenses as stated above: $40 for Parvo/Distemper $20 Dewormer $20 Nextgard $40 4DX Test $40 Health Certificate $20 Microchip $20 Bodatella $100 or more for alters Any other medical expenses incurred by the rescue for this/these dog(s)
Owners Information
Email
Phone
Your name
Date
Please sign in the box:

Draw or Type

I understand this is a legal representation of my signature. Clear

Full Name

I understand this is a legal representation of my signature.
Owners Address: Owners Address:
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Dog(s) Name:
Dog(s) Age:

DRRU - Dog Surrender Form

DRRU - Dog Surrender Form

Owners Information