Owner Release Donkeys or Horses

Form

Owner Release Donkeys or Horses
Date Date
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
Type a label Type a label Type a label Name and age of each equine, breed Donkey or Horse
Permission to Veterinarian to release records
First Name Last Name Street Address Address Line 2 City State Zip Area Code Phone Number Name, address and Phone Number of Veterinarian
Type a label Type a label Type a label Special Needs, Special Diet or Medical Conditions
Location /Address to pickup Equine

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Gender of Equine
I understand that by signing this form, I am relinquishing all rights to the surrendered animal and that Double D Animal Rescue and Community Services is solely responsible for the animals care and decisions surrounding it's care.
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I hereby certify that I am the rightful owner/keeper/caretaker of the animal who is the subject of this surrender form. I hereby surrender all property rights to the animal. I certify that no other person has the right of property to the animal. I hereby give permission to enter my property to obtain the surrendered Equine. I agree by signing below.
Date

MonthDayYear
Date
Please provide information where I can make a donation to Double D Animal Rescue and Community Services
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