Surrender Form

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Animal Intake Information

If Owned (If Stray, Skip to Next Section)

Please List Administer Dates For the Following:

If Stray (If Owned, Skip to Signature)

I hereby agree that the animal specified above, which I own or which I have custody or other knowledge of, shall become the property of the League for Animal Welfare, to be cared for or placed in a new home at the discretion of the League for Animal Welfare, without recourse on my part.

Furthermore, by signing below I understand I will no longer have contact with the animal unless they do not pass the temperament test.

Please consider a donation to the League!

Your donation helps cover the cost of vaccinations, feeding, housing and staff time caring for your and many other of our community’s animals! Thank you for helping us help other dogs and cats find their loving families.