Release of Ownership Application
All Sections MUST be Filled Out

   
Todays Date:

    _______________________________________________


Labrador Retriever Information

   
This document provides for the potential transfer of ownership of the Labrador Retriever known as:

    _______________________________________________


Did you adopt this dog from Labrador Rescuers?  If yes, what was the dogs name when he/she was with us?

    _______________________________________________


How did you hear about Labrador Rescuers?

    _______________________________________________


Sex?

    ____ Male
____ Female


Neutered or Spayed?

    ____ Yes
____ No
____ Not Sure


Is this dog microchipped?

    ____ Yes
____ No
____ Not Sure


Color? (Black, Chocolate or Yellow)

    _______________________________________________


Markings

    _______________________________________________


Height (inches)

    _______________________________________________


Weight (lbs)

    _______________________________________________


Age (weeks, months or years)

    _______________________________________________


Vaccinations given (include month and year for each vaccination):

    _______________________________________________

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_______________________________________________


This Lab has the following health problems:

    _______________________________________________

_______________________________________________

_______________________________________________


The Labrador is being relinquished because of the following reasons:

    _______________________________________________

_______________________________________________

_______________________________________________

_______________________________________________

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What is the time frame that you must relinquish your Lab?

   
Have you already, or do you intend to apply with other rescue organizations?  If YES, please explain:

    _______________________________________________

_______________________________________________

_______________________________________________

_______________________________________________

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Current Owner Information

   
Owner's name:

    _______________________________________________


Street address:

    _______________________________________________


City/State/Zip code:

    _______________________________________________


Phone Number:

    _______________________________________________


Email address: We cannot contact you otherwise!

    _______________________________________________


Description and personality traits of dog

   
Please provide as much information as possible about the dog you are surrendering.  We will use this information to describe the dog to potential adopters.

    _______________________________________________

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_______________________________________________

_______________________________________________

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How long have you owned the dog?

    _______________________________________________


Is this dog a purebred? If not, what is it mixed with?

    _______________________________________________


Please explain any aggression issues (people, other dogs, cats, etc.) that this dog has:

    _______________________________________________

_______________________________________________

_______________________________________________

_______________________________________________

_______________________________________________


If this dog was a stray, please explain the situation and also what you have done to find rightful owner?

    _______________________________________________

_______________________________________________

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Please check all that apply:

    ____ Housebroken
____ Crate-trained
____ Leash-trained
____ Paper-trained
____ Dislikes cats
____ Likes cats
____ Likes other dogs
____ Digs
____ Barks a lot
____ Can clear a fence!
____ Chews
____ Shows Shyness
____ Fights or Aggressive with Other Dogs
____ Snaps or Nips at People
____ Growls/Snaps when you Take Away Food
____ Growls/Snaps when you Take Away Toys
____ Fearful of people
____ Shows Fear of Men Only
____ Shows Fear of Women Only
____ Shows Fear of Children
____ Shouldn't be around Small Children


Where does the dog typically spend his days? Check all that apply:

    ____ Inside
____ Outside
____ Loose
____ Crated
____ Inside and Outside
____ Alone
____ With another dog
____ Kennel Run
____ Other


Where does the dog sleep at night?  Check all that apply:

    ____ In the house
____ In the garage
____ Outside
____ In a Crate


Is this dog an inside or outside dog, or both?

    ____ Inside
____ Outside
____ Both


Does the dog react poorly to any of the following? Please check all that apply:

    ____ Strangers
____ Children
____ Other Dogs
____ Cats
____ Surprises
____ Loud Noises
____ Thunder
____ Walking on Leash
____ Alone in the house (separation anxiety)
____ Alone in the yard
____ Alone in the car
____ Riding in the car
____ Does not like dog parks


Has this dog ever bitten anyone or another dog?  If yes, please explain.

    _______________________________________________


Labrador Rescuers is a 501(c)3 non-profit organization run 100% by volunteers.

All dogs prior to being adopted through Labrador Rescuers will receive a medical exam, be spayed or neutered, all vaccines brought up to date; will receive a heartworm and fecal test and be microchipped.

Donations are greatly appreciated and make it possible for Labrador Rescuers to continue helping Labs and Lab mixes with their medical care and placement into forever homes.

    _______________________________________________


Are you able to donate and help Labrador Rescuers towards your dog's care?

    ____ Yes
____ No


If you are able to donate towards your dog's care, please indicate the amount you are able to donate.

    _______________________________________________


We may not be able to take this dog due to its health, physical condition, temperament.

By submitting this form, I understand that I am applying to make available for adoption through Lab Rescuers the Lab named above if he/she passes evaluation.  I certify I am the owner of this dog, free and clear of all other interests.  

I certify that this dog is not possessed of any dangerous or vicious propensities and I have not willfully concealed information about this dog that may indicate such propensities.  The information I have provided about this dog is true and complete.  I hereby forever release, discharge and agree to hold harmless and indemnify Labrador Rescuers of San Diego, its Board of Directors, foster home providers, volunteers and agents from all claims, demands, actions, causes of action or liability of any kind whatsoever arising as a result of or in connection with the adoption of the above named dog, and/or any harm or injury caused by such dog as a result of our offering such dog for adoption, or whatever kind or nature. I further understand and acknowledge that: (1) Despite my offering this dog for adoption, no such adoption may prove possible for this dog because of either terminal illness causing unmanageable pain or over-aggressiveness toward people or other dogs that cannot be cured; (2) Lab Rescuers may have no choice but to put this animal to sleep should either of those conditions exist; and (3) my above release, discharge and agreement to hold harmless and indemnify Labrador Rescuers, its Foster Home Providers, Volunteers, and agents will also extend to, and cover, those events that may occur after I have delivered this animal to Labrador Rescuers for adoption through and until such time as this dog is put to sleep if adoption proves not to be possible for either of the above reasons.


   
ONCE CONTACTED, YOU WILL BE REQUESTED TO EMAIL OR TEXT PICTURES OF YOUR LABRADOR.  YOU MUST WILL ALSO BE ASKED TO BRING YOUR LAB TO MEET WITH ONE OF OUR VOLUNTEERS FOR AN EVALUATION AND PERSONALITY ASSESSMENT.



   

Revised 12/14/14