• STLSTR Surrender Form

  • Format: (000) 000-0000.
  • Is the dog current on it's vaccinations and Rabies shots?*

  • I hereby consent to St. Louis Scottish Terrier Rescue to contact my vet to obtain any additional information concerning this dog's medical care.

  • Provide Vet records with this release?*
  • Is the dog Spayed/Neutered?*
  • Is the dog trained?*
  • Is the dog crated?*
  • Does the dog get along with other dogs?*
  • Does the dog get along with cats?*
  • Does the dog get along with children?*
  • When the dog is left alone he is*
  • Does the dog have problems being left alone?*
  • The dog has the following personality traits: (check all that apply)*
  • Has the dog bitten/attempted to bite anyone?*
  • Is the dog destructive in any way?*

  • THIS IS A LEGALLY BINDING DOCUMENT FOR THE IRREVOCABLE SURRENDER OF YOUR SCOTTISH TERRIER FOR PLACEMENT TO AN ADOPTIVE HOME. PLEASE READ CAREFULLY AND COMPLETELY BEFORE SIGNING. TAKE AS MUCH TIME AS YOU NEED TO FULLY CONSIDER THIS IMPORTANT DECISION. IF YOU HAVE ANY QUESTIONS, PLEASE CALL: (314) 448-0460. A SURRENDER DONATION OF ANY AMOUNT IS APPRECIATED.

     

    RELEASE AND SURRENDER AGREEMENT

    This General Release and Surrender Agreement (hereinafter "the Agreement") is entered into as of this date {date} by and between the St. Louis Scottish Terrier Rescue, a Missouri not-for-profit corporation ("STLSTR"), and 

    Owner's Name: {name}
    E-mail: {email}

    (an) individual(s) residing at {address} ("Transferor").


    FOR GOOD AND VALUABLE CONSIDERATION, the receipt and sufficiency of which is hereby acknowledged, Transferor on behalf of him/herself and his/her family, heirs, executors, administrators and assigns hereby IRREVOCABLY surrenders to the STLSTR for placement and adoption, a Scottish Terrier described as follows:

    CALL NAME: {whatDo}
    SEX: {whatSex}
    DATE OF BIRTH: {dateOf}
    COLOR: {whatColor}
  • *
     / /
    2 digit month, 2 digit day, 4 digit year
  • Should be Empty: