I hereby grant sole ownership of said animal to:
- I certify that I am the legal owner of this animal.
I agree to indemnify and hold harmless Second Hand Seniors and the rescue individual agent and/or group _____________________________ from any claims arising from this animal and the transfer of it.
I further agree that the ownership of this animal can be transferred to whomever they choose without further approval or contact with me.
I also certify that this animal has never bitten nor attacked anyone to my knowledge.
Male ___ Female ___ Color _____________________________
Microchip # ______________________________
Printed Name Of Person Surrendering Pet
City, State, Zip code ______________________________________________