Bull Terrier Surrender Request "*" indicates required fields Dogs Name*Sex* Male Female Neutered or spayed* Yes No Age*Color/markings identifying CharacheristicsMicrochip Manufacturer: if applicableMicrochip NumberDate of Surrender MM slash DD slash YYYY Reason for Surrendering Above Mentioned Bull Terrier:We/Iresiding athereby wish to surrender the above bull terrier to the Bull Terrier Rescue Club of Southwest Florida (BTRCSWF). We/I relinquish to the BTRCSWF all rights of any kind we/I may have had in this bull terrier. We/I certify that We/I are/am the dog’s lawful owner and that we/I fully indemnify the BTRCSWF from all claims, suits, causes of actions and the like from or by any third party asserting an ownership interest in the dog. We/I certify that the information we/I have provided about the dog’s medical and behavioral history is true. I understand that by signing this surrender form I am forever relinquishing all ownership interests in the dog and I authorize to have the BTRCSWF place the dog into a home that has been screened for suitable placement at the BTRCSWF’s sole discretion. I understand that if the above-mentioned bull terrier is deemed to be incurably or significantly diseased or otherwise so physically or mentally unsound that treatment would be impractical or unlikely to be effective, or to have behavioral problems that make the dog a danger to person or property, the BTRCSWF may euthanize the dog, at its sole discretion, without any notice to me. I agree fully to indemnify and hold harmless the BTRCSWF , volunteers, foster homes, from all claims, demands, causes of action and the like that may arise from or pertain to the dog’s surrender and subsequent adoption or such other disposition as may be made of the dog.Owners SignatureDate MM slash DD slash YYYY Address Street Address City State / Province / Region ZIP / Postal Code Phone Number*Driver License(s)Email Annex to Surrender Agreement (Required) This information will help us place the dog in an appropriate environment. Is the dog good with other dogs? Yes No Don't Know Is the dog good with cats? Yes No Don't Know Is the dog/cat good with children? Yes No Don't Know Is the dog good with men? Yes No Don't Know Is the dog protective with food? Yes No Don't Know Is the dog protective with toys? Yes No Don't Know Is the dog housebroken?Has the dog been crate trained?Has the dog ever attempted to bite a person? Please explainHas the dog ever bitten, injured or killed another dog or another animal? Yes No Not to my knowledge If yes, explain detailsHas the dog ever attempted to injure or bite another animal? Yes No I do not know If yes, explain detailsPlease describe the dog's personality the best you can.Are you aware of any health issues with the dog?Is the dog an excessive barker? Yes No Somewhat Where and/or from whom did you purchase or adopt this dog?Is the dog current on all vaccinations and heart worm preventative? Yes No Your Current Veterinarian's NameVeterinarian's Phone NumberVeterinarian's Address Street Address City State / Province / Region ZIP / Postal Code Any other information you would like to shareCommentsThis field is for validation purposes and should be left unchanged. Δ
