Owner Surrender Form

General Information about surendering a dog. Please thoroughly read through the following information before submitting your form.

We do take owner surrenders. Our availability to take in any dog in depends on if we currently have space, our resources and if the dog has any reactivity issues or aggression.

There may be a waitlist for your dog to come into our shelter.

We require a $500 owner surrender fee/dog.

The surrender fee helps us do any requireed vetting for the dog (spay, neuter, shots), it allows us to purchase food for the dog, and a boundary collar for the property. (Please read the "About Us" section, so you have all the information about our rescue and sanctuary)

Dogs on euthanasia lists will be prioritized

Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.

Dogs Name

Dogs Breed and Sex (Male or female)

example@example.com

Dogs Age

Is your dog spayed or neutered?

Which Veterinary Clinic was your dog spayed or neutered at?

example@example.com

Is your dog up to date on shots (including rabies)

What is the reason you are surrendering your dog?

Have you considered training and exhausted all options?

By signing this Owner Surrender form, you are acknowledging that all the informaton above is true, and that you are the rightful owner of the dog listed above.

You are surrendering the dog into the care of Northern Transitional Dog Rescue and Sanctuary.

You understand that a surrender is permenant and irrevocable, you will not attemp to reclaim the dog after surrendering.

You understand that once surrendered, Northern Transitonal Dog Rescue and Sanctuary has full and sole suthority regarding the dogs care, treatment, placement, adoption or possible euthanization if the dog is assessed and labelled aggressive by our professional dog trained.

You release the staff, volunteers, and fosters from any liability associated with the dogs future behavior, placement or care.

You acknowldge that you have disclosed all known information regarding the dogs health, behavior, and history to the best of your knowledge, including any bite history or aggression.

You agree to provide copies of all available veterinary records and authorize Northern Transitional Dog Rescue to obtain them.

You agree to pay the owner surrender fee as stated above before the rescue agrees to intake your dog

By signing this agreement you certify that you arew the legal owner of this dog and have the authority to surrender it, and agree that you have read and understand the terms of this agreement.

Signature