Chicagoland Pig Rescue

(708) 257-3890
chicagolandpigrescue@gmail.com

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ANIMAL SURRENDER AGREEMENT

I hereby certify that I am the rightful owner/keeper/caretaker/custodian of the animal(s) who is/are the
subject of this Animal Surrender Form, hereinafter referred to as “the animal(s).” I hereby surrender any
and all property rights to the animal(s). I certify that no other person has a right of property to any of
the animal(s). I understand that upon the signing of this document, ownership and sole responsibility,
financial, legal and otherwise, of the animals listed below transfers to Chicagoland Pig Rescue
(Independent Rescuer)

I understand that by surrendering my property rights to the animal(s), the receiving party shall now,
without interference from me, make all decisions related to the animal(s): including, but not limited to,
basic care, sheltering, transporting, veterinary care, surgeries and treatments up to and including
euthanasia, rescue and adoptive placement, etc. as they deem fit.

I understand that once I relinquish the animal(s), the animal(s) will not be returned. I further certify that
I have read and understand the terms of this Animal Surrender Agreement.

I thereby hold Chicagoland Pig Rescue free from any claim, hindrance, liability, legal action, demand, suit
in law or equity regarding the animal(s). This includes the individuals who are involved in the
organization, and the organization as a whole.

The animal(s):

Surrendering Representative:

Representative Signature Chicagoland Pig Rescue Representative

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Date Date

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