OWNER SURRENDER TO CAMO AGREEMENT-CAMO Rescue

OWNER SURRENDER TO CAMO AGREEMENT

First Name

Last Name

Phone Number

Address

Why are you surrendering this animal to CAMO Rescue?

Animal's Name

Animal Gender

Male

Female

Is the animal spayed or neutered?

Yes

Age?

Breed?

Color?

Veterinarian Name and contact information?

Is the animal up to date on vaccinations?

Yes

Is the animal on heartworm prevention? If so, what kind and when was the last dose given?

Heartworm Status?

Negative

Positive

Unknown

Is the animal microchipped? If so, what is the microchip number?

Is the animal house and/or crate trained?

Is the animal good with other dogs?

Yes

Unknown

Is the animal good with cats?

Yes

Unknown

Is the animal good with children?

Yes

Unknown

Has the animal ever bitten anyone?

Anything else we should know?

I/We, being the owner/guardian of the forementioned animal, hereby relinquish all claims and ownership of said animal to the rescue organization known as CAMO Rescue and it’s officers. I acknowledge that said animal will not be returned to me, my family members or representatives under any circumstances. Upon completion of this contract, CAMO Rescue will have full legal rights and responsibility for this animal.

I understand that I relinquish all ownership and rights to this animal, and that full and exclusive ownership of this animal now resides with CAMO Rescue.

I have, to the best of my knowledge, answered all questions accurately and as completely as possible and have not willfully misrepresented the health or temperament of the animal.

I hereby surrender to CAMO Rescue the animal described herein.

I give permission to CAMO Rescue to obtain copies of all veterinary records.

I understand that I relieve CAMO Rescue of all liability.

I understand that this agreement will be deemed null and void should said animal be rejected during evaluation before intake.

I understand that this agreement is not final until approved by authorized CAMO Rescue personnel at time of intake.

I hereby state that I have the authority to enter into this agreement as owner(s) or keeper(s) of this animal.

I have read, understand, and agree to all terms and conditions of this contract.

Owner Signature

CAMO Personnel Authorizing Intake - For Office Use Only

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Holly Dool

Founder & President | Camo Rescue

(c) 832.520.1803 | camokennel@gmail.com