Perfect Harmony Animal Rescue & Sanctuary
Surrender/Donation contract
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Perfect Harmony Animal Rescue and Sanctuary PERFECT HARMONY

PERFECT HARMONY

ANIMAL RESCUE AND SANCTUARY

636 PALMAS ST.

CHAPARRAL, NM 88081

505-824-2130

www.perfectharmonyanimalrescue.org

ANIMAL RELEASE FORM

 

Todays Date:______________________

I, (we)___________________________________________________________________

as full owner(s) of animal known as_______________________________________________________

hereby surrender (donate) the animal to Perfect Harmony Animal Rescue and Sanctuary. I (we) certify that this transfer was agreed to by all Co-owners. I (we) agree and understand that I am (we are) giving up all rights of possession and ownership of this animal and that I (we) will not be able to redeem said animal at any time nor will it be required to inform me (us) of the animals whereabouts. I (we) agree and understand that said animal is now "Sole Property" of Perfect Harmony. I (we) promise that the information given is accurate and that Perfect Harmony will not be held liable or chargeable for any false information, or any misrepresentation, that I (we) may have submitted on this form. I (we) further agree and understand that Perfect Harmony will evaluate this animal to determine whether or not this animal will be considered "adoptable."

Owner:___________________________________________________________________________

Address:_________________________________________________________________________

________________________________________________________________________________

Phone:_______________________________

Signature:________________________________________________________________________

Co-owner:________________________________________________________________________

Address:_________________________________________________________________________

________________________________________________________________________________

Phone:______________________________


Signature:_______________________________________________________________________

PLEASE COMPLETE THE FOLLOWING:

PLEASE BE HONEST ABOUT THE ANIMALS FAULTS AND TELL US AS MUCH AS POSSIBLE ABOUT THE ANIMAL. THANK YOU.

Species:__________________________Breed:____________________________________________

Sex:____________Age/DOB:________________Spayed/Neutered: Y/N

Color:_________________________Markings:____________________________________________

_________________________________________________________________________________

Registration:_______________________________________________________________________


Vaccinations:_____________________________________________________________________

Last de-worming, brand of dewormer used:________________________________________________

Any known health problems:__________________________________________________________

Medications:______________________________________________________________________

Temperament:______________________________________________________________________

_________________________________________________________________________________

Behavioral problems:_________________________________________________________________

_________________________________________________________________________________

Feeding schedule and brand of food used:_________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

Special treats:______________________________________________________________________

Animals likes and dislikes:_____________________________________________________________

_________________________________________________________________________________

Reason for surrendering (donating) the animal:_____________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

 

SURRENDER (DONATION) OF ANIMALS IS FINAL AND CANNOT BE REVERSED. PERFECT HARMONY ANIMAL RESCUE AND SANCTUARY WILL EVALUATE THE ANIMAL AND DECIDE IF THE ANIMAL IS SUITABLE FOR ADOPTION OR WILL REMAIN IN OUR CARE AS A PERMANENT RESIDENT.

THANK YOU FOR CARING!

Animal received by:__________________________________________________________________

Date:_________________________________

 

 

 

 

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