[Back]

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:__________

Back