I am surrendering the above mentioned dog to GRSF of my own free will. I acknowledge that my signature and submission of this form relinquishes all claims of ownership of the dog described. Neither my family, any representatives acting on my behalf, nor I may assert present and/or future claims, suites, or otherwise against Golden Rescue South Florida, Inc. with respect to this dog. I understand that the Golden Rescue South Florida, Inc. will not return the dog to me, once left in its care, under any circumstances, unless otherwise approved by the Golden Rescue South Florida, Inc. Board Director.