Owner(s)/donor name __________________________________________
Address _____________________________________________________
City _______________________ Zip ___________ Phone ____________
I hereby declare that I/(we) am/are the owner(s) of the following described pet:
Cat __ Dog ____ Pet's Name _____________________________
Age _____ Sex _____ Breed ______________________________
Color/Markings __________________________________________
Medical Information _______________________________________
I do herby surrender, release, relinquish and donate ownership of the described pet to any adopting party or foster party designated by Cass River Pet FriendZ.
I am receiving no payment or other consideration for the pet. All rights, title and interest in the pet is hereby the obligation and responsibility of any foster party or adopting party designated by the Cass River Pet FriendZ.
I have read the preceding and agree to the conditions set forth
this _______day of ______________, 20 _____.
_________________________ _________________________
Signature Owner(s)/Donor Signature Owner(s)/Donor
_________________________
Cass River Pet FriendZ Rescuer
PO Box 513, Caro, MI 48723
