By checking this box, I agree to the following:
1. I/we hereby make available for adoption, the Wire Smooth (check one) Fox Terrier called by the name , to Fox Terrier Rescue.
2. I/we certify that I/we are the owner(s) of this dog, free and clear of all other parties.
3. I/we certify that this dog is not possessed of any dangerous or vicious propensities, and that I/we have not willfully concealed information about the dog that might indicate such propensities.
4. I/we certify that the information I/we have provided about this dog is true and complete.
5. I/we hereby forever release, discharge and agree to hold harmless and indemnify Fox Terrier Rescue, and any agent thereof, from all claims, demands, actions, or liability of any kind whatsoever arising as a result of or in connection with the adoption or other disposition of the above named dog.
6. I/we agree my/our name(s) and phone number(s) may be released to the new owner(s) of this dog and that the new owner(s) may contact me/us to discuss this dog.