Please note: This release is provided for information only. All dogs must be admitted by YGRR personnel who will provide you with the appropriate paperwork for each dog.

Animal Control Officer/Shelter Staff Release & Policy Statement

It is the policy of YGRR, Inc. to give each appropriate Golden Retriever every possible chance for a loving new home. However, any Golden Retriever who is found to be suffering from an incurable disease that may compromise the quality of the dog's life, or who demonstrates biting, snapping or aggression towards people, or who exhibits severe and unreasonable aggression toward other dogs, or severe behavior problems which render him unadoptable, will be euthanized.

I warrant and represent that this Golden Retriever has shown no aggression to people while in my care and that there is no documented history of aggressive behavior toward people prior to this dog's admission to my care. I understand that YGRR is relying upon this representation.

I warrant and represent that this Golden Retriever has no unexplained wounds of unknown origin that could be the result of an encounter with a wild or unknown animal. If there is an explained injury, please circle one of the following categories:

Car accident   Abuse   Fall   Other (please specify) ____________________________

This dog's emotional condition is: _____________________________

This dog's physical condition is:_______________________________

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Please complete one of the following sections:

1. This Golden Retriever was owner-released. This dog was given up because:

_______________________________________________________________

Please attach all background information and medical records you may have.
If available, the following rabies vaccination information is requested.

Immunization date: __________________(date)    vaccine: 1 yr. 3 yr. (circle one)


2. This Golden Retriever was a stray which was picked up on _________________ (date) in/on ____________________________________ (location)

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Please provide as much of the following information as possible:

Dog's name: _______________________ Gender: ________ Color: ___________

Age:_______________

Your name:_______________________________________

Title: ____________________________________________

Your signature: _______________________________ Date: _________________

Organization name: ____________________________

Street: _____________________________________

Town/State/Zip: ____________________________________

Telephone: _____________________


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