Owner Release Form

Individual Relinquishing Animal

First NameLast Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Pet's Name

Sex

Altered

Age / Date of Birth:

Breed:

Color/Description:

Weight: (estimated)

It is understood that Rescued Treasures does not buy nor pay for pets. This is a service to help place your pet in a new home when you, the present owner, can no longer keep it. This service is free; however, a donation to help pay for expenses isappreciated if you do not foster the animal while a home is found. If I foster the animal I agree to make it available, with reasonable notice, to Rescued Treasures for placement and veterinary needs.

Conditions of Release:

I, the undersigned, do hereby unconditionally release my pet to make available for adoption to Rescued Treasures, relinquishing all my rights, title, and interests in said animal. I certify that this pet is, to the best of my knowledge, healthy and does not have any sicknesses or diseases that I have not already disclosed, and I have not willfully concealed information about this.

I hereby swear that I am the sole legal owner or agent for the owner of this animal. In addition, I hereby swear that this animal has not bitten or scratched any human being or any domesticated animal within the last ten (10) days. I agree that in an extreme case, deemed unavoidable and necessary for health and/or an unsound temperament, the animal may be humanely euthanized.

Furthermore, I understand and agree to sign an adoption agreement and pay all associated fees if I should choose to keep the animal instead of placing it.

While in the program, the animal will be house at:

Moreover, I am authorizing Rescued Treasures to confirm this animal’s medical history and supplied available vetrecords. The veterinarian I used for this animal and the contact information is:

Veterinary / Clinic Name:

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Signed this "Day" Day of "Month" Year"Year"

Owner's Signature:

Owner Release Form

There shall be no further claim by this listed individual who has surrendered the following animal(s):

I certify that all statements made by me in this Owner Release Agreement are true and correct and that I have read and understand this Agreement.

These questions will help Rescued Treasures learn about your pet and answer questions from potential adopters: