Surrender Application

We Love Animals Rescue, Inc.
Surrender Application and Agreement

I hereby voluntarily and irrevocably give, donate, surrender and release to We Love Animals Rescue, hereinafter referred to as WLAR, the following animal.

* Indicates required field

Animal's name *

Dog or cat *

Dog Cat

Breed *

Sex *

Male Female

Age *

Color(s) *

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

Vet name or practice *

Vet phone *

I further acknowledge that I am releasing the Animal completely voluntarily and that no representations, considerations or promises of any kind have been made to me by WLAR or any of its representatives.

List any particular concerns or things WLAR should know about the Animal(s)—good and not so good: *

I understand that by releasing the Animal to WLAR, I relinquish all ownership or other interest in the Animal. I will not seek further information about the Animal and will not press WLAR for details. My contact with the Animal terminates at the time of surrender. WLAR is under no obligation whatsoever to follow up with information about the Animal. I hereby release and forever discharge WLAR from any and all rights, claims, obligations, liabilities, and causes of action whatsoever arising out of or relating to the ownership, possession, or disposition of the Animal, and I agree to indemnify and hold harmless WLAR from and against any and all such rights, claims, obligations, liabilities, and causes of action which may be asserted by third parties.

This is a legally binding document for the irrevocable surrender of your Animal to WLAR. I have fully read and understand this Surrender Agreement. I accept and agree to abide by its terms.

Signature (type in your name) *

First

Last

Date *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

Submit

We Love Animals Rescue, Inc.Surrender Application and Agreement

We Love Animals Rescue, Inc.
Surrender Application and Agreement