Release Form

Thank you for your interest in giving up your Airedale for adoption through Airedale Rescue Group. Please fill out this form completely. All fields are required. Also a cute picture or two should be emailed to us at info@airedalerescuegroup.com for the website. We serve North and South Carolina, Georgia, Tennessee, and Alabama and assist in other states as requested by Airedale Rescue groups serving that region.

If you are human, leave this field blank.

Name *

Telephone *

Address *

City *

State & Zip Code *

E-Mail *

Reason for giving up Airedale

Name of Airedale *

Male or Female? *

Male

Female

Neutered/ Spayed? *

Yes

No

Age/ Birthday *

Weight *

Airedale qualities/personality (check all that apply to your airedale):

Inside dog

Outside dog

Chews everything

Chained outside

Fenced yard

Uses dog door

Runs loose

Crate trained

Housebroken

Mean dog

Sweet dog

Good with kids

Bad with kids

Timid

Agressive

Loves cats

Hates cats

OK with cats

Loves dogs

Hates dogs

OK with dogs

Good on leash

Bad on leash

Digs

Loves grooming

Hates grooming

Runs away

Good in car

Bad in car

Bites

Good eater

Bad eater

Allergic to food

Special medical condition (fill in "any other medical treatment" field below)

Dominant to other household animal(s)

Aggressive to people/kids

Dog's best qualities are: *

Dog's worst qualities are: *

Has Airedale received any obedience training? *

Yes

No

If yes, please describe: *

Has dog ever bitten anyone? If yes, please describe the circumstances: *

Veterinarian's name, address, telephone number: *

Year Airedale was last vaccinated and/or tested for Rabies *

Date Airedale was vaccinated and/or tested for DHLP-P: *

Intestinal parasite exam; worms? Date *

Results and treatment:

Bordetella - Date: *

Heartworms - Date: *

Results and treatment:

Heartworm medication used: *

Flea / tick preventative used: *

How often? *

Allergies?

Any other medical treatment?

I certify ownership of the Airedale described above. This Airedale has not bitten any person or animal within 15 days and has not been exposed to rabies. I give complete ownership of the Airedale to Airedale Rescue Group and release its volunteers and representatives from any liability. *

"Digital Signature": By submitting this form, I certify that the information provided on this form is true and accurate. *

Please re-type your full name