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(for best results print with 10 point type)
OWNER'S RELEASE AGREEMENT
DATE:______ BREED:___________ SEX: M/F ALTERED: Y/N AKC#________ COLOR:________
DOG'S REG. NAME:______________________ CALL NAME:_______________________ AGE:______
OWNER'S NAME:________________________________________ PHONE:_______________________
OWNERS ADDRESS:____________________________________________________________
___________________________________________________________________________
HOUSETRAINED: Y/N CRATE TRAINED: Y/N LEASHTRAINED: Y/N BARKER: Y/N
DIGS: Y/N DOG AGGRESSIVE: Y/N JUMPS FENCE: Y/N OBEDIENCE TRAINED: Y/N
SHOT RECORD:_______________________________________________________________
WORMED:____________________________________________________________________
TYPE OF DOG FOOD:_____________________ FEEDING PERDAY: AM___ PM___ BOTH___
BREEDER:___________________________ VETERINARIAN:_________________________
DOG DOES...
Sleeps in house__ Sleep on bed or furniture__ does tricks________________
Gets along with cats__ Gets along with other animals______________________
Chews________ Ride well in car_________ Behavior with children___________
HAS YOUR DOG EVER ATTACKED ANOTHER ANIMAL: Y/N ATTEMPTED TO BITE: Y/N
HAS YOUR DOG EVER BITTEN A PERSON: Y/N ATTEMPTED TO BITE: Y/N
___________________________________________________________________________
It is understood that Rescue does not buy or pay for dogs. This is a service to
help place (your breed) in new homes when their present owners can no longer
keep them. This service is free, however a donation to help pay for expenses is
appreciated.
Please read, sign and date the following:
I,___________________________ ,hereby make available for adoption, the Fox
Terrier, named_________________________, to (the name of your rescue) RESCUE. I
certify that I am the owner of this dog, free and lear of all other interests. I
certify that this dog is not possessed of any dangerous or icious propensities,
and that I have not willfully concealed information about the dog that might
indicate such propensities. The information I have provided about this dog is
true and complete. I hereby forever release, discharge and agree to hold
harmless and indemnify the (name of your rescue) Rescue, its board of directors,
its members, officers, and agents from all claims, demands, actions, causes of
action, or liability of any kind whatsoever arising as a result of or in
connection with the adoption or other disposition of the above named dog.
OWNER'S NAME:______________________________________________ DATE:__________
I also agree my name and phone number may be released to the new owner of this
dog. And that the new owner may contact me if he wishes, to gain any further
information on this dog.
SIGNED BY OWNER:___________________________________________ DATE:__________
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