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Giving Up Your Cairn

We realize that occasionally those who have a Cairn terrier are not able to keep their dog. Perhaps a Cairn terrier is not the right dog for them. Or maybe the decision is prompted by the loss of a job, a move to a place that does not accept pets, having to move to assisted living, not having enough time for the dog, a divorce, domestic abuse, an illness or the death of the Cairn’s owner, etc.

In deciding to surrender your dog to rescue, PLEASE take as much time as you need to consider your other alternatives and make your decision. Once you have surrendered your dog to rescue, your release is legally binding and you will not be able to get your dog back. If you currently have a Cairn with behavioral problems, there are many great articles and books that deal with dogs with behavior problems. The same applies to health issues. Often, through a renewed training effort, many owners are able to keep their Cairn. We would recommend that you read: Can We Help You Keep Your Pet?. We also welcome any correspondence or questions that you may have regarding this important decision at Intakes@CairnRescueUSA.com.

If you do find it necessary to surrender your Cairn to rescue, please complete the Owner Surrender Agreement below. Please note that the final decision to accept your dog into the Cairn Rescue USA rescue program rests solely with CRUSA.

If you try to place your Cairn yourself, PLEASE spay or neuter your pet PRIOR to offering it for adoption. There are many unscrupulous backyard or puppy mill breeders who watch newspaper ads on a daily basis and present themselves as an owner looking for the perfect pet. Puppy mill brokers may even show up at your home with what appears to be their spouse and children. Registration is of no importance to mill breeders. They look ONLY for the ability to breed a purebred dog, and they will supply their own registration. Dogs are also obtained for medical research, and small dogs are obtained and used as bait in dogfights. This information is not meant to frighten you. It is intended to make you aware of the importance of screening potential new owners and taking preventive steps to protect your Cairn. Cairn Rescue USA may also be able to assist you with your placement should you decide to place your Cairn yourself.

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Release of Ownership Agreement
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This Agreement shall become effective and legally binding on the surrendering owner and Cairn Rescue USA (“CRUSA”) only if, and at such time as, the surrendering owner is informed by CRUSA’s Vice President of Intakes that his/her Cairn has been accepted into CRUSA’s rescue program and the surrendering owner has delivered possession of his/her Cairn to a CRUSA representative. Prior to such time, this Agreement shall be deemed an offer by the surrendering owner to surrender the Cairn described in Part I to CRUSA. The final decision to accept any dog into the CRUSA rescue program rests solely with CRUSA.

After completion and submission of this agreement, you should receive a copy via e-mail, so please be sure to enter a valid e-mail address.

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Part I. Intake Profile
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INSTRUCTIONS: Part I of this Release of Ownership Agreement (this "Agreement") is designed to provide Cairn Rescue USA ("CRUSA") with general information about your Cairn’s home life; to highlight any behavior problems or training needed; to help us assess your Cairn’s needs while in foster care; and to provide information that helps place your Cairn in the most appropriate home.

A. Personal Information

*Required Field
*Owner(s) Name:
Spouse Name:
*Address:
*City:
*State:
*Zip:
Home Phone:
Work Phone:
*Main E-mail:
Alternate E-mail:

B. General Information

 1. What is your Cairn's name (please include any nicknames)? 
2. Please explain in detail why you are giving your Cairn up for possible adoption:

 3. Is your Cairn a purebred Cairn or a Cairn mix?   Purebred    Cairn-Mix
 4. If mixed, mixed with what breed(s) (if known)?
 5. Is your Cairn male or female?   Male    Female
 6. How old is your Cairn? 
 7. What is your Cairn’s date of birth (if known)?
 8. How long have you owned your Cairn?
 9. How many prior owners has your Cairn had, if you know? 
10. Where did you obtain your Cairn?
   
11. What color is your Cairn?
12. How much does your Cairn weigh?
13. Is your Cairn overweight or underweight?
Underweight    Overweight    Just right
14. Is your Cairn tattooed or microchipped?
Tattooed    Microchipped    Both    Neither
15. If so, please provide the tattoo’s location, tattoo and/or microchip number, and the name and phone number of any registry used:

16. If your Cairn has any scars or distinguishing features, please describe (if none, please state):


C. Cairn's Behavior

 1. Please check any protective or possessive behavior your Cairn may display when you touch:
Treats:
Food:
Body Part:
Family Member:
Toys:
Cairn While Sleeping:
Cairn in Owner’s Bed:
 2. Has your Cairn ever bitten a person?   Yes    No
 3. If Yes, please explain:
 4. Is your Cairn housebroken?   Yes    No
 5. If No, please provide details:
 6. Is your Cairn good with children?   Yes    No
 7. If No, please provide details:
 8. Is your Cairn good with other dogs?   Yes    No
 9. If No, please provide details:
10. Is your Cairn good with cats?   Yes    No    Unknown
11. If No, please provide details:
12. Please describe three of your Cairn’s best qualities:

13. Is your Cairn frightened of anything? (check all that apply)   
Thunderstorms
Fireworks
Vehicles
People
City noises
Thunderstorms
New places
Vacuum cleaner
Other:  
14. Please check the adjectives that best describe your Cairn (check all that apply):   
Friendly
Unfriendly
Affectionate
Aloof
High Energy
Lazy
Dominant
Fearful
Rough
Gentle
Quiet
Loud
Smart
Not Bright
Stubborn
Eager to please
15. Does your Cairn:   
Jump on people?
  Yes    No
Dig?
  Yes    No
Bark excessively?
  Yes    No
Howl?
  Yes    No
Mark in the house?
  Yes    No
Suffer from separation anxiety?
  Yes    No
16. Please describe three items you wish you could change about your Cairn:

17. My Cairn would do well in a home with:
  No Kids    Kids over 13 yrs    Kids over 5 yrs    Kids of any age

  No other Dogs    With Dogs

  No Cats    With Cats

  No Visitors    Few Visitors    Many Visitors

  Someone home all day    Someone home most of day    Does not matter
18. Is your Cairn crate-trained?   Yes    No
19. Do you have a crate for your Cairn?   Yes    No
20. If Yes, what size:  
21. Will you be sending your Cairn with this crate?   Yes    No
22. If you do NOT have a crate, will you supply one of appropriate size if necessary?   Yes    No

D. Health Information

Your submission of this Agreement (i) authorizes CRUSA to contact the veterinarian listed below and obtain copies of any and all veterinary records for your Cairn if CRUSA considers it necessary or advisable, and (ii) irrevocably authorizes the veterinarian listed below to provide such records to CRUSA and candidly discuss the health of your Cairn with CRUSA.

 1. Veterinarian Information:
Name of Practice:
Doctor's Name:
Address:
City:
State:
Zip:
Phone:
 2. Under whose name are the veterinary records? 
 3. Does your Cairn need to be muzzled at the veterinarian?   Yes    No
 4. If Yes, please explain:
 5. Please tell us the most recent date your Cairn had the following shots, tests or procedures done: (if never, please state):
Rabies shot:
DHLPP shot:
Bordetella shot:
Lyme shot:
Heartworm test:
  
Internal parasites (worms) test:
  
Dental cleaning (by a vet):
 6. Is your Cairn on any heartworm preventive (such as HeartGard or Interceptor)?   Yes    No
 7. If yes, please provide the brand and date last given:

 8. If your Cairn's teeth are in need of cleaning, would you be willing to have the teeth cleaned prior to surrender or financially aid CRUSA in having this done?   Yes    No    Not Applicable
 9. Is your Cairn spayed or neutered?   Yes    No
10. If Yes, please please provide the date of spay/neuter (if known): 
11. In the case of a female Cairn, do you have any documentation to prove that she was spayed?   Yes    No    Not Applicable
12. If your Cairn has not been spayed/neutered and is less than 9 years old, would you be willing to have the spay/neuter done prior to surrender or financially aid CRUSA in having this done?   Yes    No    Not Applicable
13. Does your Cairn have (or has it ever had) any of the following health conditions:
Skin Allergies:
Epileptic seizures:
Incontinence:
Diabetes:
Cushings’ disease:
Addison’s disease:
Thyroid problems:
Luxating patella:
Hip dysplasia:
Congestive heart failure, murmur
or other heart condition:
Shortness of breath/breathing difficulty:
Kidney stones or other kidney problem:
Bladder stones or other bladder problem:
Liver problems:
Digestive problems:
Blindness, total or partial:
Deafness, total or partial:
Any other condition that requires
long-term vet care, medications
or a special diet:
14. Has your Cairn ever sustained any major injuries?   Yes    No
15. If you answered yes to any of the items listed in Questions 13 or 14, please provide details:

16. Are you able to provide a complete veterinary record for your Cairn?   Yes    No

E. Diet and Treats

 1. What brand and type of food (both dry and moist) do you feed your Cairn?
Include the measured amount fed, feeding time(s), and any special instructions for preparation (such as mixed with broth/water):

 2. Does your Cairn get table scraps?   Yes    No
 3. If your Cairn gets table scraps, how often?
 4. Is your Cairn on a special diet?   Yes    No
 5. If your Cairn is on a special diet, for what reason?

 6. Do you give your Cairn any special supplements or vitamins?   Yes    No
 7. If Yes, please list them:
 8. Do you give your Cairn any treats or special snacks?   Yes    No
 9. If yes, please list brand, type, and frequency:


F. Cairn's Activities

 1. How many hours per day is your Cairn:
Indoors:
Outdoors:
 2. When outdoors, is your Cairn:   
   
 3. How many hours per day is your Cairn left alone? 
 4. When alone, where is your Cairn kept?
   
 5. Is your Cairn allowed on the furniture?   Yes    No
 6. Where does your Cairn sleep at night?
   
 7. How does your Cairn act in the car?
   
 8. Has your Cairn had any training?
 9. What commands does your Cairn know? (check all that apply)   
Sit
Down
Stay
Come
Heel
Give paw
Other:  
10. Please provide the name and phone number of your Cairn’s trainer(s) (if any):

11. Please provide the name and phone number of your Cairn’s groomer(s) (if any):


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Part II.Terms Of Release And Surrender
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Instructions: This is a legally binding document for the irrevocable surrender of your Cairn to Cairn Rescue USA. Please read it carefully and completely before submitting it. Take as much time as you need to fully consider this important decision. If you have any questions, please contact us.

Your signature will be required prior to this Agreement becoming effective and legally binding on the parties and surrendering your Cairn. You must also provide proof of being at least 18 years old and photographic identification with your current address prior to surrender.

For good and valuable consideration, the receipt and sufficiency of which I hereby confirm and acknowledge, I, being a natural person over the age of 18 years and of sound mind, hereby irrevocably and unconditionally surrender to Cairn Rescue USA for placement and adoption, the Cairn described in Part I of this Agreement.

I understand that by executing this document, I am giving up forever all right, title and interest to such Cairn, and that all future decisions regarding the placement of this Cairn will be made solely by Cairn Rescue USA. I also understand that if this Cairn is later found to have such an unpredictable temperament as to be unsuitable for any placement, or if the Cairn's quality of life is substantially impaired, in the opinion of a competent veterinarian, by a chronic, irreversible and/or painful condition, Cairn Rescue USA may consider euthanasia as a final alternative to adoptive placement.

I represent and warrant that the information provided on Part I of this Agreement is the truth to the best of my knowledge and belief and agree (jointly and severally if this Agreement is executed by more than one owner) to hold Cairn Rescue USA, its officers, directors, representatives and volunteers, and any other group or organization that may place this Cairn in reliance on the information provided in this Agreement, harmless from any loss or injury resulting from any false information or misrepresentations that I may have submitted or made in this Agreement.

I further represent and warrant to Cairn Rescue USA, its officers, directors, representatives, and volunteers, that I (and if applicable, any other signatories to this Agreement) (i) am/are the sole owner(s) of this Cairn (ii) have full power and authority to surrender this Cairn for adoption (iii) am/are the only person(s) listed as the registered owner(s) of this Cairn with the AKC (if said Cairn is registered).

If the Cairn is AKC registered and I am in possession of its AKC registration papers, I agree to deliver to Cairn Rescue USA a properly signed transfer of the same, omitting the name of the transferee, and hereby designate and authorize Cairn Rescue USA as my agent and attorney-in-fact for purposes of designating a transferee and inserting this name on the Cairn’s AKC registration form. If the Cairn is tattooed and/or microchipped and I am in possession of documents related to the registration of such tattoo or microchip with a registry, I agree to provide copies thereof to Cairn Rescue USA.


Please make sure the application is complete (including required fields) before pressing the "Send" button below.
Incomplete applications may be rejected or delayed.

Thank You!

    


Last Update: 7-August-2006
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