Form AC219 – Rev1
Please read the following carefully:
The Calhoun County Animal Control will determine the criteria for rescue approval and will decide
which animals will be rescued. Approved rescues may always refuse any specific request due to
timing or other reasons. The Calhoun County Animal Control staff will inform you of any medical
treatments given, the length of stay in the facility and any other information we have.
I have read and understand the statements above. Further, I understand that although the
Calhoun County Animal Control takes reasonable care to screen animals for rescue placement, it
makes no guarantees relating to the animals’ health, behavior, or actions. I understand that I
receive rescue animals at my own risk
and can reject or return any animals for which the Calhoun
County Animal Control provided. I acknowledge that the rescue will be responsible for all State of
Alabama required services (spay/neuter & rabies vaccine) before the animal is placed in an
adopted home. I acknowledge that the Calhoun County Animal Control is not responsible for any
property damage or personal injury suffered by me, members of my rescue, or any third parties
during a rescue placement, and I assume all liability to provide adequate controls to prevent such
damage or injury.
Management Use Only Do Not Write Below the Line
This application has been __________ Approved __________Denied
This ________________ day of _____________________, 20____.
Signature of Calhoun County Animal Control Representative:
If denied, list the reason:__________________________________________________________