I, the undersigned, certify that I am the owner (or an authorized agent for the owner) of the stated animal, and I consent to, and order euthanasia to be performed on the said animal. To the best of my knowledge, and belief, this animal has not bitten any person or animals during the past fifteen days and has not been exposed to rabies. I give Dr. Cait and Dr. Alli (their agents, and representatives) full and complete authority authority to euthanize and facilitate aftercare of the said animal in a humane manner in accordance with the rules and regulations of the establishment. Furthermore, I forever release the doctor or representatives from any and all liability of the said euthanasia.