Pet Owner Surrender Agreement

Pet Owner Surrender Agreement

Parties

Owner Name:

Recitals

WHEREAS, Owner represents that Owner is the lawful owner of the animal described below and has the full right and authority to transfer ownership and custody; and

WHEREAS, Organization agrees to accept the animal into its custody for the purpose of sheltering, medical evaluation, and permanent rehoming, subject to the terms and conditions set forth in this Agreement; and

WHEREAS, Owner and Organization desire to document their agreement for surrender, transfer of ownership, and related obligations.

Animal Information

Male   Female   Unknown/Other

Yes   No   Unknown

Rabies   Distemper/Parvo   Bordetella   Unknown / Not current

Scope of Services

Organization will assume custody of the animal for intake evaluation, provision of routine medical care as determined necessary by Organization's veterinary staff, behavioral assessment, sheltering, and reasonable efforts to rehome the animal. Organization retains discretion to determine medically or behaviorally appropriate treatment and placement.

Owner Disclosures & Representations

Owner represents and warrants that Owner is the lawful owner of the animal, that the animal is not the subject of any lien or claim, and that Owner has the right to surrender the animal. Owner further certifies the following information is true and complete to the best of Owner's knowledge.

Payment Terms

Owner agrees to the following financial terms related to the surrender:

Term and Termination

This Agreement is effective as of the Surrender Date and remains in effect until the animal is adopted, transferred to another authorized party, euthanized for medical or behavioral reasons as determined by Organization, or otherwise disposed of in accordance with Organization policy.

Confidentiality

Organization will treat Owner's personal information as confidential and will not disclose such information except as required by law, to veterinary or behavioral professionals for the treatment or evaluation of the animal, or as necessary to carry out the purposes of this Agreement (including adoption screening). Organization may retain records of intake and treatment in accordance with its record retention policies.

Release and Indemnification

Owner hereby irrevocably releases Organization from any and all past, present, or future claims, causes of action, liabilities, costs, and expenses arising from Owner's surrender of the animal, including but not limited to claims for loss, injury, or death of the animal following surrender. Owner agrees to indemnify and hold Organization harmless from any third-party claims relating to ownership, liens, or undisclosed behavior or medical history.

Governing Law

This Agreement will be governed by and construed in accordance with the laws of the state in which Organization is located, without regard to conflict of law principles.

Entire Agreement

This Agreement contains the full and complete understanding of the parties with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, representations, and understandings, whether oral or written.

Owner Certifications

By signing below Owner certifies under penalty of perjury that Owner is the lawful owner of the animal described herein; that all information provided in this Agreement is true and complete to the best of Owner's knowledge; and that Owner voluntarily surrenders all rights, title, and interest in the animal to Organization effective on the Surrender Date.

Acknowledgement of Conditions

Owner understands that Organization may determine, in its sole discretion, the appropriate medical treatment or disposition for the animal. Owner further acknowledges that Organization makes no guarantee of adoption or specific placement and that Organization reserves the right to humanely euthanize the animal if deemed necessary for medical or safety reasons after reasonable veterinary consultation.

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