I, the undersigned, surrender my dog(s) to the South Texas Aussie Rescue, Inc. (STAR) Rescue Representative, and relinquish ownership of, and all responsibility for, said dog(s), to the Rescue Program. It is understood that STAR does not buy or pay for dogs. This is a service to help place Aussies in new homes when their present owners can no longer keep them. This service is free, however a donation to help pay for expenses is appreciated.
I certify that 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 that I have not willfully concealed information about the dog that might 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 STAR, its board of directors, its members, officers, 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 or other disposition of the below named dog.
Complete the information requested, including signatures, as indicated below. If registered, please give AKC, ASCA, or NSDR name and number, and submit registration papers and, whenever possible, the dog’s past health history, medical files and/or the name and address of the veterinarian of record.