Found Animal Surrender Contract
EARPS Exotic Animal Rescue Surrender Contract
rehoming@earps.org
(317) 809-2153
PO Box 68477, Indianapolis, IN 46268
www.earps.org
Fill out this form
ONLY
if you found the animal and
DO NOT
personally own this animal.
If you
DO
personally own this animal, please ask your EARPS representative for the owner surrender contract.
Date:
*
Full Name:
*
I certify that I am an adult and do hereby voluntarily and irrevocably give, donate, surrender, and release to EARPS Exotic Animal Rescue, herinafter referred to as EARPS, the following animal(s), herinafter refferred to collectively as "animal(s)."
Initial:
*
Animal #1 Information:
Species:
*
African Soft Furred Rat
Amphibian
Canary
Chinchilla
Crab
Crocodillian
Degu
Ferret
Finch
Fish
Frog
Gerbil
Guinea Pig
Hamster
Hedgehog
Insects
Lizard
Mouse
Other
Parrot
Pig
Pigeon/Dove
Rabbit
Rat
Skunk
Small Parrot
Snake
Sugar Glider
Tarantula
Toad
Tortoise
Water Turtle
Please describe (gender, color, personality, any known medical or behavior issues):
*
Where did you find this animal?
*
How long have you had this animal?
*
What efforts have been made to find the owner?
*
What care has been provided so far?(housing, diet, vet treatment)
*
I represent that I am not the owner, but have found or have knowledge of abandonment of the above animal(s). I have made every attempt to locate the actual owners within my ability.
Initial:
*
I further acknowledge that I am releasing the animal(s) completely voluntarily, and that no representations, considerations, or promises of any kind have been made to me by EARPS or any of its representatives.
Initial:
*
I understand that by releasing the animal(s) to EARPS, I relinquish all ownership or other interest in the animal(s). I will not seek further information about the animal(s) and will not press EARPS for details. My contact with the animal(s) terminates at the time of surrender. EARPS is under no obligation whatsoever to follow up with information about the animal(s).
Initial:
*
I hereby release and forever discharge EARPS from any and all rights, claims, obligations, liabilities, and causes of action whatsoever arising out of or relating to the ownership, possession, or disposition of the animal(s), and I agree to indemnify and hold harmless EARPS from and against any and all such rights, claims, obligations, liabilities, and causes of action which may be asserted by third parties.
Initial:
*
I understand that upon releasing the animal(s) I will not be allowed to adopt the animal(s) back from EARPS at any time.
Initial:
*
This is a legally binding document for the irrevocable surrender of your animal(s) to EARPS. I have fully read and understand this Surrender Agreement. I accept and agree to abide by its terms.
First Name:
*
Last Name:
*
Address:
*
City:
*
State:
*
Zip Code:
*
Email Address:
*
Phone Number:
*
Surrender Donation:
*
Relinquisher's Signature
*
Clear
Board Member accepting surrender:
*
Please upload a photo of the animal you have found.
*
STOP!
FORM TO BE SUBMITTED ONLY WITH PERMISSION FROM EARPS REPRESENTATIVE