Surrender Agreement

* Indicates required field

This agreement is made on this day, (insert Date) *

between Dog Adoption and (insert Owner's name) *

Owner's Address *

Line 1

Line 2

City

State

Zip Code

Country

I do hereby surrender to Dog Adoption this dog named: (insert Dog's name) *

I certify that I am the owner of this dog, free and clear of all other interests. I irrevocably relinquish unto Dog Adoption all rights, title and interest in and to the dog surrendered. I hereby forever release, discharge and agree to hold harmless and indemnify the DOG ADOPTION program, its members and agents from all claims, demands, actions, causes of action and liability of any kind whatsoever arising as a result of or in connection with the surrender and subsequent adoption or other disposition of this surrendered dog. I have read the above, I understand and agree to it. *

Yes No

Submit

Surrender Agreement

DOG ADOPTION AUSTRALIA