I hereby surrender the dog listed below to:
THE BULL TERRIER RESCUE CLUB OF SOUTHWEST FLORIDA, Inc. (BTRCSWF) and relinquish to said Rescue all rights of any kind I may have had in, or to the dog.
I certify that I am the dog’s lawful owner and I fully indemnify BTRCSWF from all claims, suits, causes of actions and the like from or by any third party asserting an ownership interest in the dog.
I certify that the information I have provided about the dog’s medical and behavioral history is true. I agree that should this information be found to be incomplete or incorrect, I may be fully liable to BTRCSWF for any veterinary or other costs that may be incurred as a result of the incorrect or incomplete information.
I understand that by signing this surrender form I am forever relinquishing all ownership interests in the dog, and I authorize to have the BTRCSWF place the dog into a home selected at BTRCSWF’s sole discretion.
I understand that if, after evaluation by a veterinarian or other canine medical or behavioral specialist, the dog is found to be incurably or significantly diseased or otherwise so physically or mentally unsound that treatment would be impractical or unlikely to be effective, or to have behavioral problems that make the dog a danger to person or property, BTRCSWF may euthanize the dog at its sole discretion, without any notice to me.
I agree fully to indemnify and hold harmless BTRCSWF, its members, officers, volunteers, foster homes, and directors from all claims, demands, causes of action and the like that may arise from or pertain to the dog’s surrender and subsequent adoption or such other disposition as may be
made of the dog.