The services of Havanese Rescue Inc include the placement of Havanese 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 always appreciated.
I hereby certify that I am the owner of the Havanese dog named
free and clear of all other interests. I agree to surrender the dog to Havanese Rescue Inc and to relinquish all ownership rights, veterinary and health records if available, and any additional information concerning the dog. It is my understanding that Havanese Rescue Inc will do what is best for this dog.
With this instrument the dog becomes the property of Havanese Rescue Inc. The information I have provided about this dog is true and complete.
certify that this animal is not vicious and has never shown signs of aggression toward human beings or other animals. (Explain on back)
*** If I fail to disclose any previous aggressive behavior (such as attempts to bite, even if no contact was made), I agree to reimburse Havanese Rescue Inc for all costs and liability it may incur because of the dog's subsequent aggressive behavior.***
I am surrendering this dog to Havanese Rescue Inc with the understanding that the organization will attempt to find the animal a suitable home. Havanese Rescue Inc and its officers will not be held responsible for the actions of the adoptive or foster families and/or the dog. If Havanese Rescue Inc deems this dog to be unsuitable for adoption due to unacceptable temperament or other reasons, I understand that Havanese Rescue Inc reserves the right to euthanize the dog.
request that should the organization decide to euthanize the dog, and every effort be made to contact me to offer the alternative of returning of the dog.
(Optional release) I agree that my name and phone number may be released to the new owner of this dog and that the new owner may contact me if they wish to gain any further information about this dog.