I am the owner, or authorized agent for the owner, of the animal described hereon and I hereby consent to, and order euthanasia to be performed for humane reasons and in a humane manner. I further attest that the animal has not bitten anyone in then last 14 days.
I also acknowledge I am the responsible party for euthanasia fees and separate removal/burial (horses) or cremation (small animals) fees associated with this service.