I, the undersigned, do hereby certify that I am the owner (or duly authorized for the owner) of the animal described above. I do hereby give the doctors of the veterinary service, their staff, and representatives full and complete authority to euthanize and handle the aftercare of said animal in whatever manner the said doctors and staff of veterinary service deem fit.
I do hereby release the said doctors of veterinary service, their staff, and representatives from any and all liability for euthanizing and aftercare of said animal.
I do also hereby certify that to the best of my knowledge the said animal has not bitten any person or animal during the last ten (10) days and has not been exposed to rabies.