Owner Surrender Form

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The following questions will be of help to the person who will adopt your dog. If there is anything you would like to add that may make your pet’s adjustment to a new home easier, please feel free to share that information. We want to make the adoption a success and will work hard to match happy owners with happy dogs.

Owner Information

First Name (required)

Last Name (required)

Address (required)

City (required)

State (required)

Zipcode (required)

Home Phone Number (required)

Alternative Phone Number

Email address (required)

Information About Your Dog

Please indicate the following information: (required)

Yes, I can keep my dog until re-homed

No, I can not keep my dog until re-homed

No, This is an emergency or my dog has urgent medical needs that I can not afford.

Please explain the emergency or medical condition in detail (required)

When does the dog need to be removed by? (required)

Dog's Name

Age/DOB

Color

Gender

Male

Female

Ears

Cropped

Floppy

Tail

Docked

Natural

Background of Your Dog

Where did you get your dog from? (required)

How long have you owned the dog? (required)

Why are you giving up your dog? (required)

Ownership Surrender Release Contract

Being the sole owner of the dog described above I hereby forever relinquish all claims to and ownership of said animal to the organization known as “Austin Boxer Rescue” hereinafter referred to as “ABR”. I understand that I cannot reclaim this dog once the dog is in the possession of ABR. It is my intent to surrender to ABR all of my ownership rights and all other interests of any kind pertaining to the dog. I understand that the final decision as to any adoption belongs to ABR. I agree to give ABR the dog’s AKC registration papers, if any, and all medical records available. ABR shall attempt to find the dog a suitable home, but the organization shall not be held responsible for the actions of the adoptive or foster family.

Agreement

When surrendering the dog please bring the following items if you have them:
Toys, bowls, crate, blankets, beds, food and any other items you may have so it will make it easier for the dog to adjust to his/her new home. In addition, we request a MONETARY donation of $50 to 100 to go toward the food and veterinary care for your dog.

Owner Signature waiver: I agree that by typing my name below, that I have read and understood the conditions of the Ownership Surrender Release Contract. Furthermore I agree to abide by the terms of the Ownership Surrender Release Contract. (required)

Date

Please click the Submit button only once. Form may take up to one minute to complete and possibly longer based upon your internet connection. You will be sent to a confirmation page once your form has been submitted and should also receive a confirmation email.

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