Rescue Transfer Form

Please sign and date to agree and accept all terms within all pages of this document. Forms without signatures and dates are discarded.

Signature: ____________________________________

Date: ________________

UNDERSTANDING AND AGREEMENT

Prior to filling and submitting this form please consult your attorney regarding each and every section to avoid misunderstanding or confusion. Do not fill and submit this form if you do not fully understand and agree with all sections of this form.

TRANSFERED FROM

Humans And Animals United Inc (HAAU)

Rosa Fond - Chief Operations Officer

16149 Twin Ct, Brooksville, FL 34614

1-813-763-1199

TRANSFERRED TO

Rescue Group*

EIN #*

Contact Name*

First Name / Last Name

Address*

City / State / Zip*

Email Address*

Mobile Phone Number*

PET INFORMATION

Pet Name*

Breed*

ID #*

Microchip #*

Date Pulled*

This contract relieves Humans And Animals United, Inc. (hereinafter HAAU) of any and all liability henceforth regarding this animal; such as medical bills, legal issues arising from the health or temperament of this animal, etc. All information provided is fully disclosed to the best of our knowledge at time of transfer, i.e., pets arriving as strays may have issues not known to us. The transfer of this pet is in the best interest of the pet itself, and upon execution of this contract the pet can be adopted out by the receiving rescue.

For HAAU transfers:

The Animal being adopted came to HAAU as a stray or was surrendered or abandoned by its previous owner, and its medical history prior to HAAU awareness is unknown. Accordingly, the Adopter or third party organization agrees to hold Humans and Animals United, Inc., (HAAU) and the Rescue Group, it’s owner, directors, employees, facilitators, family members, volunteers, associated businesses, and any and all parties with information regarding this Animal harmless from any claim related to medical care, temperament, past history, or any other related or non-related issue regarding the Animal or for Adopter’s or third party’s other pets if they contract a disease or become harmed from the Animal.

The Adopter or third party organization further understands that animals can be unpredictable and hereby acknowledges and agrees that HAAU, the Rescue Group, and their respective agents, volunteers, and employees have not made any warranties regarding the future condition, temperament, or conduct of the Animal. HAAU maintains sole ownership of the animal until an adoption has been made. The rescue the animal is being transfered to relinquishes all rights to the animal to HAAU. If HAAU or the shelter the animal was pulled from requests to receive the animal back in thier posession, then the rescue shall relinquish the animal back to HAAU within 48 hours.

The Adopter or third party organization hereby accepts the Animal “as is” and agrees to assume all risks and responsibilities associated with ownership of the Animal, including bites or physical harm to another animal or human.

The Adopter or third party organization further agrees to release, indemnify, and hold harmless HAAU and the Rescue Group and their respective officers, employees, agents, and instrumentalities from any and all liability, losses, or damages, even if caused by the sole negligence of HAAU or the Rescue Group, including attorneys’ fees and costs of defense, as a result of any claims, demands, suits, causes of actions, or proceedings of any kind or nature, whether known or unknown, arising out of, relating to, or resulting from the adoption, care, ownership, maintenance, retention, temperament, conduct, or condition of the Animal.