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Maremma Sheepdog Club of America
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ABOUT MSCA
Who We Are
FIND A MAREMMA
What is a Maremma Sheepdog?
Historical Timeline
Breed Standard
Breeders Directory
MSCA Puppies and Adults Available
MSCA Maremma Sheepdog FAQ
Suspensions
MEMBERSHIP
Join and Become a Member
MSCA Code of Ethics Enforcement Guidelines
RESCUE
SHOP
NEWS
Join Now!
$
0.00
0
Cart
ABOUT MSCA
Who We Are
FIND A MAREMMA
What is a Maremma Sheepdog?
Historical Timeline
Breed Standard
Breeders Directory
MSCA Puppies and Adults Available
MSCA Maremma Sheepdog FAQ
Suspensions
MEMBERSHIP
Join and Become a Member
MSCA Code of Ethics Enforcement Guidelines
RESCUE
SHOP
NEWS
Log in
Maremma Sheepdog Club of America
MSCA Owner Surrender Form
OWNER SURRENDER Information: Maremma Sheepdog
Today's Date
MM slash DD slash YYYY
Dog's Name
Age
Purebred/Mixed
Purebred
Mixed
Sex
Male
Female
Spayed/Neutered?
Yes
No
If neutered, #
Why are you surrendering this Maremma Sheepdog? (Please provide as much information as you can.)
Where did you get the dog? (Breeder etc)
Where are you located?
Please describe the dog’s current situation
Active LGD
Farm Dog/Property Guardian
Pet
History of Behaviour
Has the dog scratched or bitten a person in the last ten (10) days?
Yes
No
If yes, who was bitten
Date of Bite
MM slash DD slash YYYY
In what city?
Has the dog ever
Bitten
Scratched
Lunged or attacked
None of these
If yes, did a bite break the skin?
Yes
No
Was Animal Control involved?
Yes
No
Please explain the circumstances
The dog’s veterinarian
City
Phone
Is the dog current on vaccinations?
Yes
No
Please list any past or present injuries, treatments or other medical history
Check all of the following that describe the dog
Very active
Couch potato
Barks alot
Quiet
Playful
Friendly
Fence Jumper
Shy
Likes to be touched
Affectionate
Fearful
Independent
Protective
Always at your side
Indoor dog
Outdoor dog
Nervous
House-Trained
Crate-Trained
Likes men
Likes women
Has the dog lived with or been around children?
Yes
No
If so, what ages
Would you recommend your dog live with children in the future?
Yes
No
Has the dog lived with dogs?
Yes
No
If yes, describe the other dogs
What type of Livestock (if any) has your dog protected/been around
Do you have any concerns about your dog being around livestock in the future?
Yes
No
If yes - please explain
Would you recommend your dog live with dogs in the future?
Yes
No
What does the dog dislike or fear?
Where is the dog kept during the day?
Where does the dog sleep at night?
Does your dog travel well in the car?
What type of food do you feed your dog?
Is there anything else a future owner should know about this dog?
My signature below certifies that I am the owner of, or have the authority to surrender to MSCA Rescue Society, the animal described above. I hereby relinquish all rights of ownership and any right to information on the disposition of said animal. I also authorize the release of any veterinary records regarding the animal. I certify that to the best of my knowledge I have disclosed all information about the animal concerning health, behavior, history and anything else that may affect the safe placement of the animal in a new home, and that all statements made above are true and correct.
Signature
Date
MM slash DD slash YYYY
Name
First
Last
Address
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antarctica
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bonaire, Sint Eustatius and Saba
Bosnia and Herzegovina
Botswana
Bouvet Island
Brazil
British Indian Ocean Territory
Brunei Darussalam
Bulgaria
Burkina Faso
Burundi
Cabo Verde
Cambodia
Cameroon
Canada
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos Islands
Colombia
Comoros
Congo
Congo, Democratic Republic of the
Cook Islands
Costa Rica
Croatia
Cuba
Curaçao
Cyprus
Czechia
Côte d'Ivoire
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Eswatini
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Guiana
French Polynesia
French Southern Territories
Gabon
Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Heard Island and McDonald Islands
Holy See
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Isle of Man
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
Korea, Democratic People's Republic of
Korea, Republic of
Kuwait
Kyrgyzstan
Lao People's Democratic Republic
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macao
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syria Arab Republic
Taiwan
Tajikistan
Tanzania, the United Republic of
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
US Minor Outlying Islands
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Venezuela
Viet Nam
Virgin Islands, British
Virgin Islands, U.S.
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Åland Islands
Country
Phone
Email
Consent
(Required)
I agree.
I hereby acknowledge that I have been notified of and fully understand the following conditions of my relinquishment of this animal. MSCA shall have sole and exclusive legal right to make all outcome decisions and take all actions deemed appropriate, including return to owner, adoption, or euthanasia.
The MSCA Rescue Society spends an average of $450 on food, shelter, medical and other care for each animal in our care. If you are able, please consider making a donation to help us care for your Dog. Thank you!