I hereby voluntarily and irrevocably give, donate, surrender and release this animal to Passport for Paws. I represent and warrant that I am the lawful owner of the Animal, and I have full power and authority to surrender the Animal to this rescue. No other person has any legal or equitable ownership interest in the Animal.
I have disclosed to Passport for Paws all material information regarding the medical and behavioral history of the Animal. I willfully surrender all medical records and information pertaining to the Animal. The rescue has my permission to contact my veterinarian for any necessary information pertaining to my Animal, and I hereby consent to the release of any and all medical information by any medical provider.