Owner Surrender Form

  • Animal Identification

  • What name does your dog respond to?
  • Medical Information

  • Please tell us what Animal Hospital your dog visits.
  • Animal Care


    I agree and understand that by submitting this form and upon acceptance of rehoming my dog by VSR, I am giving up all rights of possession and ownership of this dog to Vegas Shepherd Rescue (“VSR”). Upon signing this release, I will not be able to reclaim the dog, nor will I be entitled to any information about the dog, including its condition or location.

    I agree and understand that said dog is now "sole property" of VSR. By signing below, I represent that the information is accurate and that I will hold VSR harmless from any claims or damage that may arise from my supplying false or misleading information on this form. I further agree and understand that VSR will evaluate this dog to determine whether or not the dog being surrendered will be considered "adoptable". The rescuers cannot guarantee placement.
  • Please fill in the blank
  • Surrendering Owner Information