Estimate if necessary
Please enter microchip type and number or tattoo number if applicable
Estimate if necessary
If you answered yes to the last question, please describe what happened here.
I hereby attest that all of the above information is true and correct to the best of my knowledge. I further acknowledge that I am the owner of the dog and that I am fully authorized to relinquish any and all right, title and ownership of the above mentioned dog. I acknowledge that there exists a possibility that he/she will be euthanized if he/she exhibits uncontrolled or unprovoked aggression, or if he/she exhibits any other behavior which would make him/her a liability or cause harm to anyone. This determination may be made at the sole discretion of MidAmerica Rottweiler Rescue. Please type your name and date below.