RR - Transfer & Liability Release Form

To Regina’s Rescues; subject to Regina’s Rescues continuing to maintain its status as a non-profit corporation, as described further below. Said owner states under oath, that this animal is owners to surrender; to the best of said owners knowledge has not bitten anyone and has no diseases transmissible to humans.

Said owner (stated below) gives Regina’s Rescues, full & immediate possession and waives rights to the animal(s) listed below.   Said owner is aware that Regina’s Rescues will take responsibility for the animal(s) needs.  Said owner gives permission to Regina’s Rescues to adopt the pet to a new family, should the opportunity arise.

Regina’s Rescues releases said owner from all liability concerning said animal(s), and will make every attempt to provide adequate care and find a permanent home, either with Regina’s Rescues itself, foster, or with a placement family.

Please note that we will need to collect a hard copy form once you do bring the animal to the rescue. Please also make sure that you have your ID with you to ensure that we have a smooth transfer of the animals rights over to the rescue.


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Date of Surrender 
MM
/
DD
/
YYYY
Owners Name who is surrendering animal  *
Please enter your name as it is stated on a legal proof of ID
Name of animal  *
Enter animals name 
What type of animal and gender? *
Required
Neutered/Spayed *
Required
Microchipped
*
Required
Contact info
Phone number *
E-mail
Preferred contact method *
Required
Questions and comments
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