Owner Surrender Request | Dog Rescue Form

Complete our online owner surrender request dog rescue form for placement consideration of your dog by Lifeline Dog Rescue. We accept Weimaraners and other breeds of dogs and reserve the right to reject dogs that may not meet our standards for successful adoption. Please read the following statement carefully before completing the actual form.

Statement of Owner and Surrender Request Form

I voluntarily surrender my dog as named and described in the form below to Central Florida Weimaraner & Dog Rescue, Inc., dba Lifeline Dog Rescue, and request that you provide reasonable care and place my dog for adoption. I certify that I am the legal owner. I certify that I will submit complete and truthful information on this form prior to submitting. I further certify the dog has never bitten or been aggressive towards a human.

I fully understand any attempts to mislead or falsify information may result in my dog being denied acceptance to Lifeline Dog Rescue, and facts contrary to my statements discovered at a later date subsequent to said surrender whether intentional or unknown by me could result in the surrendered dog being transferred elsewhere or destroyed without notice.

I agree to remit the surrender fee of $100.00 payable to Central Florida Weimaraner & Dog Rescue, Inc., at the time of surrender unless otherwise agreed upon. I further agree that typing my name and the date at the bottom of this form is legally binding as an electronic signature and confirms that I fully understand and accept the terms of this agreement.

Owner Surrender Request Form

How did you find Lifeline Dog Rescue?
MM slash DD slash YYYY
Dog's gender
Spayed or neutered?
How was the dog acquired?
Which of these does your dog know and like?
Which of these commands does your dog obey, if any?
Which positives describe your dog?
Which negatives describe your dog, if any?
Has your dog ever snarled or snapped at a person or dog?
Has your dog ever bitten a person or other animal?
Has your dog displayed fear of any of the below?
Please check all current or prior physical health issues:
Max. file size: 100 MB.
Max. file size: 100 MB.
Max. file size: 100 MB.
MM slash DD slash YYYY
This field is for validation purposes and should be left unchanged.

Date of Establishment

October 24th, 2011

501c3 Eligibility Status


US Federal EIN Number


Note: International donors must check local tax regulations to confirm if contributions are deductible in their country.