SECOND CHANCE ALL BREED DOG RESCUE by 9n13FS

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									            SECOND CHANCE ALL BREED DOG RESCUE
                           Fredericksburg, VA 22406
                                 540-752-1741
                         www.2ndchancedog.petfinder.com
                               lmr735@aol.com

                                                        Date

I, _____________ & ___________________ hereby release to Second Chance All Breed
Dog Rescue (name) _______________, (breed) ____________________,
(description)__________________________(Age)_________


Signature_____________________

Name ________________________

Address _______________________

______________________________

Phone # _______________________


I (name) _____________________ hereby accept above mentioned dog from the above
mention person or persons. (Authorized representive of Second Chance All Breed Dog
Rescue)

Signature ___________________Date_______________________



                                                                  (OVER)

								
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