Skip to main content
Close Search
Chesapeake Bay Retriever Relief & Rescue
search
Menu
  • Adopt
    • Adoption Process
    • Available Rescue Dogs
    • Adoption Options
  • Surrender
  • Volunteer
    • Member Application
    • Foster Application
  • Find a Rescuer
  • Fundraising
    • CBRR&R Goods
    • Shop our Supporters
    • Make a Donation
    • Recurring Monthly Donations
    • Sponsor a Chessie in Need
    • Honorary and Memorial Funds
    • Corporate and Matching Gifts
    • National Fundraising Partners
  • Resources
    • Breed Info
      • Breed Characteristics
      • Do I really want a CBR?
      • Don’t Buy a CBR
    • Blog & Social
      • CBRR&R Blog
      • Social Media
      • Calendar of Events
    • CBRR&R Alumni
    • Success Stories
    • In Memory
    • Resource Center
  • Contact
    • About
    • Contact Us
    • Privacy Policy
  • Log In
  • Donate Now
  • search
  • Menu

Surrender Application

For owners wishing to surrender a dog.

"*" indicates required fields

Please add the required information in the form below and once required data is populated & approved the Gift Release will be presented for signature. Document may also be emailed for signature depending on the information provided.
MM slash DD slash YYYY

Contact Information:

Name:*
Address*
Please Enter your Primary Phone Number Here. This could be Mobile, Home, or Business.
Please enter Mobile phone number. This number may be used to send a text confirmation of your submission, and a link to allow you to come back to form to continue later or edit.
Email:*
To help us direct your application to correct Rescue resources. Please select CBR Region matching the State of your Application Address.

Dog Information

Please enter a number from 10 to 200.
Please enter dog's weight in pounds, estimate if you do not know exact weight.
Gender:*
Spayed / Neutered:*
Purebred CBR:*
Please Provide Breeder Name, if you know what Breeder the dog was acquired. (provide City, State, website of Breeder if known)
Is there a location tag on dog? If so, please provide ID of Tag and provider.

Family Makeup

Dog lives with:
Animals dog lives with:

Temperament & Training

Likes?
Is your dog?:
Does your dog:
Can you leave him unattended in the house for long periods of time?

Vaccinations

Is your Dog current on Vaccines (check if current):
Heartworm Positive:

Reason for Surrender:

Drop files here or
Accepted file types: jpg, gif, png, pdf, jpeg, Max. file size: 10 MB, Max. files: 5.
    Please add Photos of Dog to be surrendered. Please try to take photos of dog without other dogs, children or people in photo. (We know you love to so off your other children, but these photos will potentially be used on our website.)
    Hidden

    Upload Photo's

    Post Image
    Accepted file types: jpg, jpeg, png, gif.
    Post Image
    Accepted file types: jpg, jpeg, png, gif.
    Post Image
    Accepted file types: jpg, jpeg, png, gif.
    Post Image
    Accepted file types: jpg, jpeg, png, gif.
    Post Image
    Accepted file types: jpg, jpeg, png, gif.
    This field is for validation purposes and should be left unchanged.

    Support our rescue efforts please make a Donation Donate

    Adoption Success Stories

    • Jake and Zoe, a Bonded Pair June 2, 2022
    • Our Angel Sy June 1, 2021
    • Prineville 5 Update February 17, 2021

    CBRR&R

    • Adoption Process
    • Available Rescue Dogs
    • Surrender
    • Volunteer
    • Foster
    • Make a Donation
    • Resources
    • Contact Us

    GuideStar

    guidestar silver

    We’re Top Rated

    Chesapeake Bay Retriever Relief And Rescue Inc Nonprofit Overview and Reviews on GreatNonprofits

    © 2022 Chesapeake Bay Retriever Relief & Rescue. All rights reserved.
    Web development by tStreet & imaginary_trout

    • facebook
    • pinterest
    • youtube
    • instagram
    Close Menu
    • Adopt
      • Adoption Process
      • Available Rescue Dogs
      • Adoption Options
    • Surrender
    • Volunteer
      • Member Application
      • Foster Application
    • Find a Rescuer
    • Fundraising
      • CBRR&R Goods
      • Shop our Supporters
      • Make a Donation
      • Recurring Monthly Donations
      • Sponsor a Chessie in Need
      • Honorary and Memorial Funds
      • Corporate and Matching Gifts
      • National Fundraising Partners
    • Resources
      • Breed Info
        • Breed Characteristics
        • Do I really want a CBR?
        • Don’t Buy a CBR
      • Blog & Social
        • CBRR&R Blog
        • Social Media
        • Calendar of Events
      • CBRR&R Alumni
      • Success Stories
      • In Memory
      • Resource Center
    • Contact
      • About
      • Contact Us
      • Privacy Policy
    • Log In
    • Donate Now
    • About >CBRR&R NP Info
      • About CBRR&R
      • Mission Statement
      • Corporate Information
      • FAQS
    • Register