Barn Animal Surrender Application
NOTE: Completing this form does not guarantee we will accept this animal into our agency. Rescue Village reserves the right to decline surrender requests at its discretion. We kindly ask that all interactions with our staff remain respectful. Any use of inappropriate behavior may result in refusal of services.
Name
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First Name
Last Name
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
County?
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Please Select
Geauga
Lake
Ashtabula
Portage
Cuyahoga
Trumbull
Mahoning
Summit
Other
Phone Number
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Please enter a valid phone number.
Email- if you do not have email type in: intake@rescuevillage.org
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example@example.com
Are you wanting to surrender a herd or flock of animals?
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No, only one animal to surrender
Yes, I have a herd or flock to surrender
If you have a herd/flock, how many animals do you need to surrender?
Where did you originally get this animal(s)?
Species?
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Age(s)?
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Male/Female? If multiple, how many of each?
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If possible, please upload a photo of the animal(s)
Browse Files
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Reason for surrender?
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What is the current housing situation for this animal/these animals? Give as much detail as possible:
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Is this animal/are these animals healthy? If not, what health issues are you noticing?
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Anything else you would like us to know about the barn animal(s) you are needing to surrender?
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NOTE: Poultry that were purposely hatched and/or purchased from a chain store as chicks and then grew up to be males that you do not want will be evaluated for intake on a case by case basis as we have very limited housing for poultry. Please note that if this is your situation you will most likely be given alternative resources for placement.
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I understand
Not applicable, I am not surrendering male poultry.
I understand that I MUST have an intake appointment and that Rescue Village does not accept walk-in surrenders.
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I understand
I understand that Rescue Village requires an intake fee of $50 to help offset the cost of caring for this animal during it's time with us. Under certain circumstances, we can reduce or waive this fee, but it must be discussed with the Intake Manager prior to your intake appointment
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Please Select
I understand and can provide the full fee.
I understand, but am asking for a reduced fee.
I agree to check my email (including my junk/spam folder) regarding important communication from Rescue Village in regards to this surrender form:
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Please Select
I agree and will check my email AND junk/spam folder
I do not have email and will require a phone call
I understand that Rescue Village is NOT an open admission shelter and that Rescue Village is a limited admission, unlimited stay humane society. I understand my application can be denied for any reason.
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Please Select
I agree and understand that Rescue Village may deny my application for any reason.
I do not agree and will seek other options. I understand I will not be contacted by selecting this option.
By signing below, I understand that Rescue Village has the right to deny my surrender form for any reason. I also understand that if my surrender form is accepted, there may be a lengthy wait because Rescue Village does NOT euthanize animals for time or space reasons and can only schedule in animals as barn space allows.
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Submit
Should be Empty: