Adoption Group Name:
Address:
City/State:
Phone:

CONTRACT OF SURRENDER

I/We _______________________________________hereby agree to surrender

my/our greyhound to Adoption Group:___________________ (hereon referred to as xxx,Inc.)

today,_______________ because_____________________________________________

I/We understand that I/we cannot reclaim said greyhound.

I/We further understand that said greyhound will be placed in a new home at the discretion of Adoption Group, Inc., and in consideration of all parties involved, the whereabouts of said greyhound will not be shared.

I/We am/are hereby released of any and all future obligations and/or responsibilities of said greyhound.

This agreement between _______________________________ and Adoption Group, Inc. is final and binding.

NAME OF DOG: ________________ TAG #:________________

RIGHT EAR #: ________________LEFT EAR #: __________________

DESCRIPTION: ______________________________________________

ORIGINAL PLACEMENT THROUGH Adoption Group____. OTHER_____________

SURRENDERED BY:

________________________________________________
Signature of Owner                      Date
________________________________________________
Signature of Co-Owner (if applicable)  Date

SURRENDERED TO:

________________________________________________
Signature of Adoption Group Representative Date