TOTALLY FLOCKED AVIAN RESCUE PARROT SURRENDER
Your Full Name
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Your Address, City, State, Zip
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Your Phone Number
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Your Email
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Bird's Name
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Bird's Species & Color
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Bird's Age
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Bird's Band # if any
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Has the bird been ill, or been disease tested?
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Tell me about the bird? Personality, likes, dislikes, favorite foods, injuries, special needs and/or helpful tips.
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How long have you owned the bird?
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Any information on prior homes the bird has lived in?
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What is the reason for surrender?
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Amount of donation (not required) offered to help us cover the cost of vetting/caring for this bird?
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I, the undersigned, agree with the following statements:
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I hereby surrender and forfeit any and all property/ownership rights to the bird.
I certify that no other person has a right of property to the bird.
I understand that by surrendering my property rights to the bird, the bird may be rehomed/adopted to an approved adopter.
I understand that once I relinquish the bird, the bird will not be available to be returned.
I further certify that I have read and understand the terms of this Parrot Surrender Form
I hereby certify that I am the rightful owner/keeper/caretaker/custodian of the bird(s) who is/are the subject of this Parrot Surrender Form, hereinafter referred to as “the bird.”
Today's Date
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