Surrender Application

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    Good With:

    Enter the date of most recent vaccination:

    I understand if my animal is not up to date on vaccines, current on heartworm preventative, or neutered or spayed, there is a $100 owner surrender fee payable to Indy Great Pyrenees Rescue Inc. to help offset the expense of getting the animal treated by a licensed veterinarian.

    If the dog is taken into rescue by Indy Great Pyrenees Rescue, I agree that this dog is being surrendered because I no longer can care for the pet or want to be responsible for it in anyway. To my knowledge the animal does not display vicious behavior towards humans. I understand if an animal behaviorist determines the animal is not suitable for adoption, it will be euthanized in a humane manner.

    The animal will be placed in a suitable family home as a companion and pet, and will not be used for testing. I understand that by signing this document, I cannot ask for the animal to be returned to me or my family, no matter what the circumstances. I also understand I will not be able to visit the animal in its new home, and the adopters’ identity or location will not be revealed unless the adopter agrees.

    I give authorization to my veterinary clinic to release all medical records regarding the have mentioned dog to Indy Great Pyrenees Rescue Inc..

    Typed name will serve as a signature.