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BCFS SURRENDER DOCUMENT - FARM
This is a legally binding document for the irrevocable surrender of your animal for placement to an adoptive home or to become a long term member of BCFS. Please read this document carefully and completely before signing. Take as much time as you need to fully consider this important decision. Surrender fees are as follows:

1. $100 – for the private surrender of any 1 (one) animal that is currently unaltered (not spayed or neutered)
2. $50 – for the private surrender of any 1 (one) animal that has already been altered (is spayed or neutered)
3. Additional monies given to complete all vet care necessary for this animal (checkup, shots, dental work, etc.) are always welcome and are greatly appreciated.

I understand that by surrendering my animal, (whose ownership I have proven to BCFS), I am relinquishing all control and ownership in perpetuity. The animal hereafter belongs to BCFS and I have no further rights, claims, or assignments. Nothing in law permits me to resile from this agreement and I am aware of that and in consideration of the care to be rendered to BCFS, I hereby enter this contract.

IT IS UNDERSTOOD THAT THIS SURRENDER DOCUMENT NEEDS TO BE APPROVED BY BEAVERCREEK FARM SANCTUARY BEFORE THE ACTUAL SURRENDER TAKES PLACE AND BEAVERCREEK FARM SANCTUARY HAS THE RIGHT TO REFUSE A SURRENDER. A BCFS REPRESENTATIVE WILL BE IN CONTACT.
TERMS OF RELEASE AND SURRENDER FOR ADOPTION
I/we the undersigned, hereby IRREVOCABLY surrender this animal to BCFS for placement and adoption:
Name: *
Your answer
Address: *
Your answer
Email:
Your answer
Phone Number: *
Your answer
Please let us know why you are surrendering your animal.
Your answer
Animal's Call Name: *
Your answer
Animal's other name if registered:
Your answer
Species *
Your answer
Breed *
Your answer
Gender *
Age
Your answer
Birthdate
Your answer
Color
Your answer
Markings
Your answer
I.D. (microchip # or Tattoo):
Your answer
Registered with:
Your answer
Date of Spay or Neuter? If applicable (rabbits, pigs)
Your answer
Date of Rabies, if applicable (pigs & horses)
Your answer
Date of Erysipela (pigs)
Your answer
Date of Tetanus (pigs & horses)
Your answer
Date of Encephalomyelitis (horse)
Your answer
Date of West Nile Virus (horse)
Your answer
Date of EHV (horse)
Your answer
Date of Influenza (horse)
Your answer
Date of Potomac horse fever (horse)
Your answer
Date of Strangles (horse)
Your answer
Last time de-wormed?
Your answer
Last time hooves trimmed? (horse, pig, goat)
Your answer
Full name of Vet and contact information
Your answer
Animal's manners:
Any problems with behaviour?
Your answer
Animal's experience with Kids (ages)
Your answer
Is animal good with other animals? Problems?
Your answer
Bad habits: (chewing, digging, soiling, etc.)
Your answer
Any surgery or dental work done: (vet clinic info)
Your answer
Any health problems we should be aware of?
Your answer
Animal prefers: (check all that apply)
If animal prefers kids, what ages is animal good with.
Your answer
Experience with: (Check all that apply)
Where is animal kept?
Your answer
What does the animal eat, how much and when, Hay (kind), grain (brand)
Your answer
Overall opinion of the animal's temperament:
REPRESENTATIONS AND WARRANTIES
Please initial after each clause
1. I/we hereby represent and warrant to BCFS, their agents, successors, and assigns that the undersigned are the sole owner(s) of the above-described animal. Former owner’s initials: *
Your answer
2. That I/we have full power and authority to surrender this animal for adoption, that I/we are the only person(s) who are listed as registered owner(s) of this animal, that no other person or persons signatures are required to effect a valid transfer on this animal, and that no other person or persons have any legal or equitable ownership interest in this animal. Former owner’s initials: *
Your answer
3. PERTINENT INFORMATION. I/we agree to provide BCFS with any documents, registration papers and all other available information concerning this animal which might assist in matching this animal with the proper prospective adoptive home, including health and inoculation records, pedigree, or other person from whom the animal was acquired, and information concerning the history. Former owner’s initials: *
Your answer
4. CONSENT FOR CONTACT. I grant my permission for all prior veterinary records and known medical history to be submitted to the BCFS. Former owner’s initials: *
Your answer
5. SURRENDER OF RIGHTS. By executing this document, I/we understand that I/we are giving up forever all right, title and interest to the above-mentioned animal and I/we further understand that all future decisions regarding placement of this animal will be made solely by BCFS. I/we also understand that if this animal is later found to have such an unpredictable temperament as to be unsuitable for any placement, or if the animal's quality of life is substantially impaired, in the opinion of a competent veterinarian, by a chronic, irreversible, painful condition, euthanasia may be considered as a final alternative to adoptive placement. Former owner’s initials: *
Your answer
6. I/we, the undersigned, hereby specifically and forever release and hold BCFS harmless from any and all liability arising from the placement for adoption by BCFS of the above-mentioned animal or for any other actions taken by BCFS in accordance with and reliance upon the representations and warranties I/we have made herein and the authorization I/we have provided under the terms of this document. I/we agree to indemnify and hold harmless BCFS for any and all damages suffered and expenses incurred (including legal fees) in defending any legal action, whether for bodily injuries or death, property damage, breach of contract, or otherwise, whether instituted by me/us or by any other person or persons including the adoptive owners, arising out of or in consequence of the placement of the dog, in reliance upon the authorizations, representations and warranties I/we have made in this agreement. Former owner’s initials:
Your answer
7. I/we certify that this animal is not possessed of any dangerous or vicious propensities and that I/we have not willfully or knowingly concealed any information about the animal that might indicate such propensities. I/we have read the preceding and agree to the conditions set forth herein. Former owner’s initials:
Your answer
Signature(s) of Owner(s)
Your answer
Date of surrender
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