I, ________________________________________(Please Print), hereby donate to TEXAS Old English Sheepdog RESCUE, Inc. (TXOESR) the Old English Sheepdog:

__________________________________________________________ (Name of dog).

I certify that I am the legal owner of this dog and hereby turn over full and sole ownership of said dog to TEXAS Old English Sheepdog RESCUE, Inc.   I agree to indemnify and hold harmless TXOESR from any claims arising from this animal and the transfer of it.

Furthermore, I understand that this dog will be evaluated by TXOESR volunteers as to the dog's temperament and suitability for placement. If the dog is deemed inappropriate for placement, I authorize TXOESR to make whatever humane choice is necessary, including the possibility of euthanasia.

I (do)/(do not) wish to have a final report on placement of this dog.

Donation: ___________________

Signature of owner ______________________________________

Date: _______________

Owner Address: _____________________________________________

Owner Phone #: (____) ____________________ email: ___________________________

Witness:______________________________________

Date: _____________