Owner Surrender Contract
Funds for Furry Friends Owner Surrender Contract
The following document outlines the terms of agreement when surrendering a dog to Funds for Furry Friends Dog Rescue. These terms explain and identify the terms of the ownership transfer.
Dog Information
Dog Name:
*
Dog Breed(s):
*
Age
*
Gender
Tattoo or Microchip Number (if applicable):
Have you completed the Dog Surrender Request form and been accepted before submitting this contract? (please note that this surrender contract is only for dogs that are being accepted into the rescue. If you have not received confirmation that your dog is accepted, please refer to the Dog Surrender Request Form)
*
Yes, my dog has been accepted into rescue
No, my dog has not yet been accepted into rescue
Due to the expenses incurred by the rescue, we do request a donation from the owner for the dog entering rescue to assist with costs (such as food, vet care, boarding, grooming, transportation, etc.) Will you be providing a donation to assist with these costs?
Yes
No
I will be providing a donation via supplies
If yes, please indicate amount or detail of donation.
Transfer of Ownership
Terms of Surrender
Legal Obligations
Privacy Policy
Vet Clinic Information
Please provide all vet records for the above named dog, or list the vet clinic that can provide these records, if applicable.
Name and Contact Number of Veterinary Clinic: I give permission to the below-named veterinarian clinics to release any and all information pertaining to the dog and agree to have the file transferred to Funds for Furry Friends for their permanent records.
*
Upload any and all vet records for the above named dog here:
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Owner Contact Information
This information is obtained and kept on file as a means of contacting you should there be a problem with the information you have provided to us or should a dispute arise regarding ownership of the dog you are turning into rescue:
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Electronic Signature
The terms and agreements outlined in this document are legally binding. I agree that I am aware of the terms of agreement outlined in this document, and by providing my electronic signature below I acknowledge that I have read and agree to the terms as outlined by Funds for Furry Friends in this document. My electronic signature also provides verification that I have received a copy of these terms of agreement for my own records
Owner Signature
*
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