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United States Kerry Blue Terrier Club Rescue

OWNERS RELEASE AGREEMENT

Kerry Blue Terrier
Name of Dog________________________________________

Age_______ Sex__________Color______________________

Reason for Relinquishment__________________________

___________________________________________________

I, the undersigned, do hereby unconditionally release my animal to USKBTC Rescue, relinquishing all my rights, title and interests in said animal. I hereby swear that I am the sole legal owner, or agent for the owner of this animal. I agree that if USKBTC Rescue, in an extreme case, deems it unavoidable and necessary for health reasons and/or unsound temperament the animal may be humanely euthanized.

Name(Print)________________________________________

Address____________________________________________

City,State,Zip_____________________________________

Phone______________________________________________

Signature__________________________________________
(Note: USKBTC Rescue does not sell animals for research)

 

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RELEASE AGREEMENT RECEIPT

I,____________________________________, acting as a representative of USKBTC Rescue, will accept this dog and will deliver this dog to a USKBTC Rescue approved foster home.

USKBTC Rescue assumes full responsibility for the dog at the time of this transaction. At this time the GIVER, relinquishes all responsibility for this dog.

USKBTC Rescue will treat this dog according to it’s established procedures for placing dogs.

Signature of USKBTC Rescue Representative

__________________________________________________

Address___________________________________________

City, State, Zip__________________________________

Phone_____________________________________________

Date______________________________________________

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