INFORMATION FORM
For shelters,
foster homes (not affiliated with PointerRescue.Org, Inc.)
and owner "give-ups"

(Purebred Pointers only,
--no-- mixed Pointers or other pointing breeds such as the German Shorthaired Pointer)


Please note: If you are an owner giving up your dog, be aware that there are special requirements and a fee for posting non-shelter/rescue/humane organization listings. You will be contacted by a PRO representative about these requirements/fee once you submit this form and prior to your information being posted.

DOG'S NAME: DOG'S AGE:
DOG'S SEX: DOG'S COLOR:
SPAYED/NEUTERED?: REGISTERED?:

WHERE IS DOG LOCATED:
CITY  STATE

 

DOG HAS BEEN VACCINATED FOR:
RABIES
One-Year
Three-year
DATE
DHL-P DATE
Kennel Cough DATE
Parvo DATE
Corona DATE
Lyme DATE
Giardia DATE

HEARTWORM: Heartworm Status
On HW Preventative
Needs HW Treatment

WEIGHT: or in Pounds
HEIGHT (at shoulder):

REASON DOG PUT UP FOR ADOPTION:

ABOUT THIS DOG: NEEDS WORK ON:
Good with Kids
Good with other dogs
Good with cats
Good with other animals
Has had basic obedience training
Shows pointing instinct
Has been hunted over
Digs
Destructive chewer
Jumps on people
Jumps fences
Gets up on counters
Gets on furniture
Barks
Whines
Not housebroken
Dog aggresive
Timid around strangers
Afraid of men
Afraid of women
Afraid of children
Sensitive to noises
Gunshy

Other

If you have a photo of the dog in .jpg, .bmp, or .gif format, please indicate here:

Contact person
Organization
Title
Address
Phone
E-Mail
Fax

Person submitting this information (if other than contact):
Info Submitter
Organization
Title
Address
Phone
E-Mail
Fax

Dog will be put to sleep if not adopted/fostered by:

I/we certify that I/we, the contact person listed above and/or the submitter of this information, am the legal owner or custodian of, or am authorized by the owner or legal custodian of, the above-referenced dog to post this information.  I/we certify that all submitted information is correct to the best of my/our knowledge and belief.  I/we agree that PointerRescue.Org, Inc. (PRO) and/or its designee(s) have the right to refuse, and might not post, any information provided by me/us for any cause which PRO and/or its designee(s) deem to be sufficient. 

In consideration of the acceptance of this information and the opportunity to have this information posted on the Internet by PointerRescue.Org, Inc. and/or its designees, I/we agree to hold PointerRescue.Org, Inc. (PRO), its officers, members, volunteers, coordinators, fostering agent(s), agents, its Internet service provider(s), Internet presence provider(s), webmaster(s), the American Pointer Club, Inc., the American Kennel Club, and any employees of the forementioned parties, harmless from any claim for loss or injury which may be alleged to have been caused directly or indirectly to any person or thing by the act of this dog and I/we personally assume all responsibility and liability for any such claim; and I/we further agree to hold the aforementioned parties harmless from any claim for loss of this dog by disappearance, theft, death or otherwise, and for any claim for damage or injury to the dog, whether such loss, disappearance, theft, damage, or injury, be caused or alleged to be caused by the negligence of PointerRescue.Org, Inc. or any of the parties aforementioned, or by the negligence of any other person, or any other cause or causes.

I/we hereby assume the sole responsibility for and agree to indemnify and save the aforementioned parties harmless from any and all loss and expense (including legal fees) by reason of the liability imposed by law upon any of the aforementioned parties for damage because of bodily injuries, including death at anytime resulting therefrom, sustained by any person or persons, including myself/ourselves, or on account of damage to property, arising out of or in consequence of my/our provision of information to, sharing information with, and/or participating in any cooperative efforts with PointerRescue.Org, Inc. including any handling, fostering, health-related support, or transporting by PointerRescue.Org or any of the aforementioned parties for the above-referenced dog or any other dog or dogs that might be in my/our care or possession, howsoever such injuries, death or damage to property may be caused, and whether or not the same may have been caused or may be alleged to have been caused by negligence of the aforementioned parties or any of their employees or agents, or any other persons.

By clicking the I AGREE button, I/we assert that we have carefully read and reviewed the foregoing and agree to be bound by all terms and conditions therein .