Surrender Application.

Surrender Application.

Let’s start with your information.
Name*

First NameLast Name
Email*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number. This is how we will contact you to followup.
Reptile / Amphibian Information.
Species *
Gender (if known)
Age (if known)
How long have you had this animal? *
Where did you acquire this animal? (Breeder, pet store, rescue, etc.) *
Why are you surrendering the animal? *
Can you please upload any recent images you have of the animal? *

Cancelof
Health and Behavior.
Any current health concerns or past illnesses?

YesNo
Tell us more about this animals health. *
Is the animal currently under vet care?*

YesNo
Can you provide the vets information? (Business name, doctor name, phone number, etc.)*
How is your animal's shedding habits? Do they shed well? How often? Does shed ever get stuck?*
What does your animal's feeding schedule look like? (How often are you feeding, what are they eating, are you using any supplements or vitamins, are you free feeding or tongue feeding, etc.)*
Has the animal ever shown aggression or unusual behavior?*

YesNo
Please tell us more.*
Habitat.
Do you have any equipment or an enclosure you’d like to surrender the animal with? As a nonprofit rescue our animals are helped by anything given to us.*

YesNo
Describe the current habitat set up you have the animal in. (Tank size, type, heating, lighting, substrate, decor, hides, etc.) *
How often is the habitat cleaned?*
Agreement.
Please read the following legal release carefully. By checking the box and signing below, you confirm your understanding and acceptance of the following terms:

I certify that I am the legal and rightful owner of the animal(s) I am surrendering to Reigning Reptile Rescue.

I hereby voluntarily and permanently surrender all ownership rights, responsibilities, and claims to the animal(s) named in this form.

I understand that Reigning Reptile Rescue is not obligated to return the animal(s) to me once surrendered, and that all decisions regarding care, treatment, rehabilitation, and placement for adoption are at the sole discretion of the rescue.

I understand that the animal(s) may be evaluated, treated, fostered, adopted, or humanely euthanized, depending on their health, temperament, and overall condition, as determined by the rescue’s team or veterinary partners.

I affirm that I have provided complete and truthful information about the animal(s)’ health, history, behavior, and current condition to the best of my ability.

I release Reigning Reptile Rescue and its staff, volunteers, and affiliates from any future claims or liability associated with the surrendered animal(s).
Do you agree to the terms above?*

Yes, I agree to the terms of surrender legal release.
Clear
Should be Empty:

Surrender Application.

Reptile / Amphibian Information.

Health and Behavior.

Habitat.

Agreement.