Owner Surrender Form

 * Denotes Mandatory Fiels

Owner Information:

Name*

Pet Information:

Surrender Agreement

I/We transfer all of our rights, title, and interest of the above noted pet(s) to VIP Rescue of Central Florida, Inc.

VIP Rescue of Central Florida, Inc. may take such actions it sees fit with the pet(s) including medical attention necessary and placement into another home. We relinquish all rights, title, and interest as of this date. I/We authorize VIP Rescue of Central Florida, Inc. to obtain any necessary veterinarian records for this dog. I understand that VIP Rescue of Central Flrodia, Inc.is a not-for-profit volunteer organization, and we release it from all liability or responsibility of any kind.