Name of Owner *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Primary Phone Number *

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Alternate Phone Number

(###)

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I, the owner, certify that this is MY true and accurate personal information. *

I agree

-I understand that there is some risk inherent in the procedure(s) and in the use of anesthetics and drugs used to provide this service. I do understand that these risks could result in the injury or death of this animal. *

I agree

I certify that this animal is in good health and is at least eight weeks of age. *

I agree

I hereby release Purrfect Pawprints Animal Rescue including its officers, directors, agents, volunteers, the vet clinic Purrfect Pawprints is using to perform surgery on your pet from all claims arising out of or connected with the performance of sterilization surgery, or other procedure(s). I agree that I have not or will not claim any right of compensation from Purrfect Pawprints Animal Rescue, or file any action based on the sterilization of such animal(s) or other agreed-upon services provided on behalf of the animal(s) or any consequences related thereto, including claims related to the possibility of this/these animals not having been vaccinated prior to the provision of services. *

I agree

I understand that this contract may be specifically enforceable by Purrfect Pawprints through judicial proceedings due to any breach of the terms this contract holds. *

I agree

I hereby agree that in the event I breach this contract and Purrfect Pawprints files suit to enforce this contract or to defend any claim under this contract, or if I file suit against Purrfect Pawprints and the court rules in favor of Purrfect Pawprints, that I will pay any court costs and attorneys' fees incurred by Purrfect Pawprints in connection herewith. *

I agree

Date

MM

DD

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