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Surrender Form

Surrender Formadmin2021-05-07T15:22:44-04:00

Owner Surrender Form

Surrenderer's Info

Are you the legal owner of the boxer you are wanting to surrender?(Required)

Dog's Info

Is the Boxer a male or female?(Required)
Is the Boxer spayed or neutered?(Required)
Is the boxer microchipped?(Required)

Dog's Health Info

Is Boxer currently receiving heartworm preventative?(Required)
Is Boxer currently on flea/tick preventative?(Required)

Dog's Character Profile

Does your Boxer have separation anxiety?(Required)
Does your Boxer display food or toy aggression?(Required)
Where does your Boxer live?(Required)
Is your Boxer house/potty trained?(Required)
How is your boxer with other dogs? Check ALL that apply:(Required)
Does the Boxer do well with children? Check ALL that apply(Required)
Does the Boxer currently live with other pets?(Required)
Does your Boxer currently live with children?(Required)
Has this Boxer ever nipped, snapped at or bitten anyone?(Required)
Has this Boxer shown aggression towards other dogs or people?(Required)
Max. file size: 256 MB.
Max. file size: 256 MB.

Consent

I understand that by submitting this form, Coastal Boxer Rescue of Florida Inc. (CBR) is under no obligation to accept my boxer into their rescue program. I understand that a CBR representative will contact me to discuss the information on this form. I understand that if my Boxer is considered a good candidate for an available CBR foster home, I will relinquish all claim to my boxer and allow CBR to place him or her into their adoption program.(Required)
I understand that by submitting this form, Coastal Boxer Rescue of Florida Inc. (CBR) is under no obligation to accept my boxer into their rescue program. I understand that a CBR representative will contact me to discuss the information on this form. I understand that if my Boxer is considered a good candidate for an available CBR foster home, I will relinquish all claim to my boxer and allow CBR to place him or her into their adoption program.
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By Clicking on “SUBMIT” you agree to the above statements and that you have filled out this form truthfully and to the best of your knowledge.

This field is for validation purposes and should be left unchanged.

Coastal Boxer Rescue utilizes the online donation services provided by PayPal. You do not need to have a paypal account in order to donate through paypal. You can choose to pay through your PayPal account or with your credit or debit card.

If you prefer to mail in your donation, checks can be mailed to:

Coastal Boxer Rescue of Florida
P.O. Box 121381
W. Melbourne Fl. 32912-1381.

* Please make checks payable to: Coastal Boxer Rescue of Florida Inc.

A COPY OF THE OFFICIAL REGISTRATION AND FINANCIAL INFORMATION MAY BE OBTAINED FROM THE DIVISION OF CONSUMER SERVICES BY CALLING TOLL-FREE (800-435-7352) WITHIN THE STATE.  REGISTRATION DOES NOT IMPLY ENDORSEMENT, APPROVAL, OR RECOMMENDATION BY THE STATE.  Coastal Boxer Rescue of Florida, Inc. state registration number is CH21576.  None of your contribution is retained by any professional solicitor.  100% of your contribution goes towards our operating costs, primarily the medical care for our foster Boxers.

Address: P.O. Box 121381, W. Melbourne Fl. 32912-1381 | Phone: (866) 281-8209 | eMail: info@coastalboxers.org |

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