GRRAND Surrender Contract

GRRAND Surrender Contract

GRRAND Owner Surrender Contract

Owner #1 Name(Required)
Owner #2 Name
Address(Required)
Dog #1 Name(Required)
Dog #2 Name
Has your dog(s) ever bitten a person?(Required)
Has your dog(s) ever bitten another animal?(Required)
Describe here
Signature Authorization(Required)
By checking this box and typing your name below, you are signing this contract electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this contract.
Signature of Owner/Relinquisher #1
MM slash DD slash YYYY
Sigature of Owner/Relinquisher #2
MM slash DD slash YYYY
Signature of GRRAND Representative
MM slash DD slash YYYY

Authorization to Release Veterinary Records to GRRAND

Name of Veterinarian(Required)
Provide the name of your veterinarian. If you do not presently have a veterinarian and have never taken your pets to a veterinarian, please enter "NA."
Address
Describe pets and breeds here. If you have not had pets in the past please enter NA.
Signature for Authorization to Release Medical Records from Your Veterinarian(Required)
By checking this box and typing your name below, you are signing this contract electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this contract.
Whose name is on the vet account?(Required)
MM slash DD slash YYYY
This field is for validation purposes and should be left unchanged.
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