Surrender Agreement - Helping Outside Animals

Surrender Agreement

Helping Outside Animals
I hereby certify that I am the rightful owner, keeper, caretaker, or custodian of the animal(s) described in this Animal Surrender Form (hereinafter referred to as “the animal”). I voluntarily and irrevocably relinquish all rights of ownership and any legal claim to the animal. I certify that to the best of my knowledge, no other individual holds a legal right to the animal.

I understand that by surrendering my rights, the animal may be placed in the care of a rescue organization or other responsible entity. I acknowledge that once the surrender is complete, the animal will not be returned to me under any circumstances.

I further certify that I have read, understood, and agree to the terms outlined in this Animal Surrender Form.
Name*

First NameLast Name
Email*
example@example.com
Phone Number
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Describe the animal (Species, age, color, any identifying markings)
Spayed/Neutered
Health Condition

GoodFairPoor
Are vaccination records available?
Picture of the animal

Cancelof
Please provide details on why you are surrendering ownership of the cat*
Name of Vet Clinic he/she sees.
Authorization and Agreement:

Authorization to Surrender: I, the undersigned, authorize the surrender of ownership of the above-named cat to Helping Outside Animals.

Release of Information: I understand that the information provided on this form may be used by Helping Outside Animals for the purpose of rehoming the cat and may be shared with potential adopters.

Health Records Release: I authorize the release of any available health records and veterinary information related to the cat to Helping Outside Animals.
Signature*

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Date Signed

MonthDayYear
Date
Should be Empty: