Animal Surrender Form

I certify that I legally own the animal(s) identified above (including on any attached lists or sheets) and that no other person has any rights or interests in those animal(s). I acknowledge that my e-signature on this receipt relinquishes all claims of ownership of those animal(s). Neither my family, any representatives acting on my behalf, nor I may assert present and/or future claims, suits, or otherwise against the above named agency with respect to those animal(s). I understand that above named agency will not return those animal(s) to me, once left in its care, under any circumstances, unless otherwise approved by the above named agency. I am also aware that those animal(s) may be humanely euthanized if behavioral and/or medical problems render those animal(s) unsuitable for adoption

I further acknowledge that my e-signature on this receipt grants permission to the above named agency or its agent to enter and remove any and all animals within address described above. Neither my family, any representatives acting on my behalf, nor I may assert present and/or future rights, claims, suits, or otherwise against the above named agency with respect to such animal(s). I hereby agree to release, indemnify and hold harmless the above named agency, its past, present, and future officers, directors, agents, employees and volunteers from and against any and all liability, claims, suits, actions, judgments, costs, fees, including any and all attorney’s fees and damages caused by and/or arising out of and/or in connection with such animal(s).