Equine Release/Surrender Agreement
TERMS OF RELEASE AND SURRENDER FOR ADOPTION:
1. I/we, the undersigned, hereby IRREVOCABLY surrender and relinquish to the Equine Rescue Resource Inc. (ERR) for placement and adoption, the following equine (horse, pony, mule, donkey):
CALL NAME:
SEX: _______ AGE: _______
REGISTERED NAME:
REGISTRY: REGISTRY NUMBER:
PLEASE ATTACH REGISTRATION PAPERS
IDENTIFICATION NUMBERS (TATTOOS OR BRANDS):
COLOR: MARKINGS:
RIDEABLE: YES NO DISCIPLINE:
GOOD WITH CHILDREN: : YES NO (IF NO, PLEASE EXPLAIN):
AGGRESSIVE: YES NO (IF YES, PLEASE EXPLAIN):
VICES:
REASON FOR SURRENDER:
SHOTS RECEIVED WITHIN THE LAST 12 MONTHS:
FEEDING SCHEDULE (WHAT AND WHEN):
SPECIAL NEEDS:
MAJOR MEDICAL ISSUES WITHIN THE LAST THREE YEARS (IF AVAILABLE):
OTHER COMMENTS:
2. REPRESENTATIONS & WARRANTIES - We hereby represent and warrant to ERR , their agents, successors and assigns that the undersigned are the sole owner(s) of the above described equine. That I/we have full power and authority to surrender this animal for adoption, that I/we are the only person(s) or organization/corporation who are listed as registered owner(s) of this animal, that no other person or persons' signatures are required to effect a valid transfer of ownership and registration papers on this animal (if available), and that no other person or persons have any legal or equitable ownership interest in this animal
3. DELIVERY OF REGISTRATION - I/we agree to contemporaneously with the execution of this document to deliver to ERR a properly signed transfer of all registration papers for the above described equine, omitting the name of the transferee.
4. OTHER PERTINENT INFORMATION - We also agree to provide ERR with any documents and all other available information concerning this equine which might assist in matching this equine with the proper prospective adoptive home, including health and shot records, pedigree, name and address of breeder or other person from whom the equine was acquired, and information concerning this equines "history," such as important life events and individual personality quirks.
5. CONSENT FOR CONTACT - We understand that ERR may contact the breeder or previous owner of the equine to provide additional background information, or otherwise
assist in locating a suitable adoptive home and hereby give our consent to these efforts.
6. SURRENDER OF RIGHTS - By executing this document, we understand that we are giving up forever all right, title and interest to the above-mentioned equine and we further
understand that all future decisions regarding the placement of this animal will be made
solely be ERR. We also understand that if this equine is later found to have such an unpredictable temperament as to be unsuitable for any placement, or if the animal's quality of life is substantially impaired, in the opinion of a competent veterinarian, by a chronic, irreversible, painful condition, euthanasia may be considered as a final alternative to adoptive placement.
7. RELEASE AND INDEMNITY - I/we, the undersigned, hereby specifically and forever release, hold ERR harmless, from any and all liability arising from the placement for adoption by ERR of the above-mentioned equine, or for any other actions taken by ERR in accordance with, and in reliance on, the representations we have made, and the authorizations we have provided under the terms of this document. We agree to indemnify and hold harmless ERR for any damages suffered and expenses incurred including legal fees in defending any legal action, whether for bodily injuries or death, property damage, breach of contract, or otherwise, whether instituted by us or by any other person or persons including the adoptive owners, arising out of or in consequence of the placement of the equine, in reliance on the authorizations, representations and warranties we have made in this agreement.
I understand that Equine Rescue Resource Inc. will make every effort to find a suitable home for my equine following its normal adoption procedures, with certain exceptions (i.e. those that must be euthanized upon recommendation of a licensed veterinarian). I hereby give up all right, title and interest to the above referenced equine voluntarily and without coercion or threats of any kind.
THIS IS A LEGALLY BINDING DOCUMENT FOR THE IRREVOCABLE SURRENDER OF YOUR EQUINE FOR PLACEMENT TO AN ADOPTIVE HOME. PLEASE READ CAREFULLY AND COMPLETELY BEFORE SIGNING. TAKE AS MUCH TIME AS YOU NEED TO FULLY CONSIDER THIS IMPORTANT DECISION. IF YOU HAVE ANY QUESTIONS, PLEASE CALL: (718) 404-3904 ext. 3564.
I have read the preceding and agree to all conditions set forth this ______ day of _ _________, in the year ______.
BY:
PRINT (INDIVIDUAL NAME and NAME OF BUSINESS IF APPLICABLE)
SIGNATURE
ADDRESS:
TELEPHONE:
WITNESS:
PRINT (INDIVIDUAL NAME and NAME OF BUSINESS IF APPLICABLE)
SIGNATURE
ADDRESS:
TELEPHONE:
ERR requires a hard copy of this form, complete with the original signatures of owner(s) or authorized representatives from a transferring organization/corporation, certifying the above information.
Please print & complete this form and mail to:
EQUINE RESCUE RESOURCE INC. P.O. Box 158 Throggs Neck Station Bronx, NY 10465
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