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You can fill out the information below, or download the PDF and mail or fax it to us.

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  • SURRENDER FORM

  • ABOUT YOU (The Releaser):

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  • ABOUT THE DOG

  • THIS AGREEMENT ("Agreement") is made and entered into this day o submission (“Effective Date”) between  Colorado Peke and Pom Rescue, Inc. (CPPR)  (hereinafter referred to as “Rescue Group”) and submitter (hereinafter referred to as “Releaser”, whether one or more persons).

    WHEREAS, in order to protect and preserve the breeds (Pekingese, Pomeranians, Papillion’s, other) collectively known as “Precious Personalities” of Colorado Peke and Pom, Inc.  the Rescue Group accepts from individuals, animal shelters, humane societies and other persons and entities, Precious Personalities  which are unwanted, abandoned, neglected, lost or mistreated; and 

    WHEREAS, the Rescue Group temporarily houses, feeds and provides medical and other care for such dogs with the goal of placing dogs permanently in suitable homes through a unique adoption process that results in the Rescue Group retaining ownership while the adoptive family takes conditional possession of such dogs (“Rescue Group Program”); and

    WHEREAS, Releaser wishes to release to Rescue Group the above-described dog for placement in the Rescue Group Program and in doing so understands that Releaser is conveying to Rescue Group all right, title, possession and interest in and to said dog forever.  

    NOW, THEREFORE, in consideration of the foregoing and the terms and conditions expressed herein below, the sufficiency of which is hereby acknowledged, Rescue Group and Releaser agree as follows:

    1. The Rescue Group agrees to accept into the Rescue Group Program the above-described dog.
    2. Releaser is asked to donate a minimum of $25.00 or more to help defray the costs of the Rescue Group.  Failure to pay in no way undermines or alters the sufficiency of the above-stated consideration.
    3. As of the Effective Date, Releaser voluntarily releases and otherwise conveys to Rescue Group forever all right, title, possession and interest in and to the above-described dog.  Releaser acknowledges and agrees this conveyance is being done absent any duress or coercion on the part of Rescue Group or any third party and that Releaser shall forever be barred from making any claim to the contrary as well as any claim of ownership or right to possess said dog .  Releaser represents and warrants that Releaser is the owner of this dog and has the full and complete legal right to convey ownership and possession and to release said dog to the Rescue Group.  Releaser shall hold harmless Rescue Group and its agents relative to any breach by Releaser of this representation and warranty.
    4. Releaser hereby provides full disclosure of all known information regarding the temperament, behavior characteristics and medical problems and treatment of the dog not already outlined above follows: 
    1. The Rescue Group assumes all responsibility for the dog’s care and its actions after Rescue Group takes possession of the dog.  The Rescue Group agrees to hold Releaser harmless for any care and actions related to the dog after Rescue Group takes possession of the dog; providedhowever , no such indemnity is provided if Releaser has failed to fully disclose the dog’s history, including but not limited to acts of aggression or biting.
    2. This Agreement is governed by the laws of the State of Colorado. 

    BY CLICKING ON THE SUBMIT BUTTON, YOU HAVE ACKNOWLEDGED AND AGREED:

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HOTLINE: (303) 681-2512

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Colorado Peke and Pom Rescue, Inc. (CPPR)
PO Box 242, Morrison, CO 80465







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