By signing my name, I certify that I am the person identified in this application and that this will be considered my electronic signature. I certify that all information provided herein is true and correct and that Carolina Boxer Rescue, Inc. or it’s agent will not be held liable or chargeable for any false information, or any misrepresentations, that I have submitted on this form.
1) I have agreed to submit an application by electronic means.
2) I understand the questions on this form and understand that giving false or misleading information will disqualify my dog from being able to be surrendered.
3) I certify that all my answers are true, correct and complete to the best of my knowledge.
4) I understand that an electronic signature has the same legal effect and enforceability as a written signature on an application.