DOG - MA PET RESCUE
New Owner Name:
Phone #: E-Mail:
Age: Sex: Spay / Neuter:
Color / Distinguishing Markings: Microchip:
Temperament (training/behavioural issues):
For Dog - Ma Pet Rescue:
Application Received: Approved:
Phone #: E-Mail:
The ownership of the pet ____________ as described above, is being transferred and relinquished
from the responsibility and control of Dog - Ma Pet Rescue to the new owner
. A fee for the amount of _________ will be paid to Dog - Ma Pet Rescue
to cover some of the veterinary costs for this animal and others in our care.
This pet will be placed spayed or neutered, and microchipped. It is understood that this pet is a
pet companion and will never be tied up, or housed outside, but will occupy housing with the new
owner. A suitable fenced yard will be provided adjacent to the home of the new owner unless
otherwise agreed. The feeding program will provide optimal nutrition and hydration as required by
this pet. Proper veterinary care will be provided including heartworm, flea and other parasite
The new owner understands that this pet must be returned without cost to Dog - Ma Pet Rescue if
the owner at anytime relinquishes ownership. In addition, the owner agrees to receive and / or
return Dog - Ma Pet Rescue phone calls or e-mails regarding this pet and will permit home visits if
Dog - Ma Pet Rescue so wishes.
The new owner also agrees that any evaluations completed (physical and temperament) are for
informational purposes only and the pet is being placed with no guarantee or warranty of any kind.
The new owner agrees to release and hold harmless Dog - Ma Pet Rescue from any and all liability
in connection with the placement of this pet.
Date of Owner Transfer :
Signature for Dog - Ma Pet Rescue: Signature of New Owner:
Send completed form to:
Dog - Ma Pet Rescue
C/O Kate Gartley
105 Mortimer Avenue
Toronto, Ontario M4K 2A3
or by e-mail:
Cheques should be made out to Kate Gartley. In the note section please print the pet's name and
adoption fee. If you wish to pay the adoption fee by Visa / Mastercard arrangements can be made
to pay the fee directly to our veterinarian. All adoption fees are non-refundable.