Earth Services
P.O. Box 25
Bellevue, MI 49021
269.965.2117

Animal Relinquish Contract:

I _______________________ here by sign over my animal(s) to:
        Owner of said animal

Educated Animal Rescue and Teen Haven on the _____ day of __________.

1st Animal ___________ _________ ____ ____ _______________________
                        Name            Breed      age    sex               description

2nd Animal ___________ _________ ____ ____ _______________________
                        Name            Breed       age   sex              description

3rd Animal ___________ _________ ____ ____ _______________________
                        Name            Breed       age   sex              description

The said animal(s) will now be under the care of Earth Services. You will not have the option to re-claim your animal(s) by signing the animal(s) over. The said animal(s) will be placed up for adoption if the animal is fit to be adopted, and once you have signed this contract you relinquish all responsibilities and ownership of the said animal(s) to Earth Services. Relinquish fee is: ______ Earth Services initials_______

__________________ __________ _______________________ __________
Adoption Counselor          date               Owner of said animal(s)           date

Earth Services
website@earthservices.org
P.O. Box 25, Bellevue, MI 49021
269.965.2117

Telephone: __________________________

Veterinarian used for Animal(s): __________________________