Surrender Request

This application is not a binding agreement. Appicant is under no obligation to surrender the dog and Canine Castaways Rescue Inc. is under no obligation to accept the dog from the applicant. All applications are subject to acceptance based on dog's needs, as well as rescue capacity and abilities. All decisions are based soley on judgment of coordinators of Canine Castaways Rescue Inc. Acceptance of applications submitted through this form may be denied for various reasons. By submitting your completed application, you attest that you have read the above disclaimer and agree to the terms therein. Furthermore, you represent that the information you have provided on this form is the truth to the best of your knowledge and belief. I hereby forever release, discharge and agree to hold harmless and indemnify Canine Castaways Rescue Inc., its board of directors, and its members, Officers and agents from all claims, demands, actions, causes of action or liability of any kind whatsoever arising as a result of or in connection with the acceptance of a dog from applicant, to this organization.

In consideration of your acceptance of this surrender acceptance form, I for myself, my heirs, executors, administrators and assigns, forever release and discharge any and all rights, demands, claims for damages and causes of suit or actions, known and unknown, that I may have against Canine Castaways Rescue Inc, and any and all participating sponsors and the directors, officers, employees and agents of such parties, for any and all injuries resulting from my visit to Canine Castaways Rescue Inc. I attest and verify that I have full knowledges of the risks that may be involved in visiting Canine Castaways Rescue Inc., and that I assume those expenses.