RELEASE FORM

Your tax deductible donation of $ ______ is used 100% for the welfare and 
veterinary care of the animals while they are with us. Donations are the 
only form of income we have. Please give generously for the dogs who will 
live the rest of their lives with us in their sanctuary.

Today's Date: ___________ 

Releasing owner's name: _________________________________________________

Address: _______________________________________________________________

City: ___________________________ State: ______________ Zip: ____________

Tel: (home) ________________ (bus) ________________ (cell) ______________

E-Mail: _________________________

I unconditionally release the animal described below to Beagles and Buddies 
and certify that the information provided herein is true to the best of my 
knowledge:

Dog's full name ___________________________ Nickname______________________

Breed ________________________________ 

Sex ____________________ Color ___________________

Spayed or neutered? Yes or No 

Age _____________ Weight ________________________


Please provide accurate dates for the latest vaccinations:

Dhlp-p ___________________ Bordatella ________

Rabies __________________   Other _________________________

Do you have the receipts for the vaccinations? Y N (circle)

If NO, name of vet/clinic where vaccines given _____________________________

Remarks to help us place the pet:

Well behaved? Yes No 

Good with other dogs? Yes No

Good with cats? Yes No 

Good with children? Yes No
 
Leash Trained? Yes No
 
Housetrained? Yes No

Other important things that we should know that will help us place 
him/her in the most suitable home:




Reason(s) for releasing dog:




I certify that I am the owner of the animal described herein. I understand 
that there are no written or verbal guarantees given or implied regarding 
the placement of this animal other than BEAGLES AND BUDDIES best efforts 
to find a good home for the pet. I promise to provide vaccination records 
as indicated above as well as any other pertinent medical information.
To the best of my knowledge, the above described animal has not bitten 
anyone during the last ten (10) days.

I (pick one) DO or DO NOT  authorize new adoptive parents to contact me 
concerning the above described animal.

Signed: ___________________________________________ 
Dated: ______________________________