Rabies Vector Species Release Form

Rabies Vector Species Release Form

4 Wilderness Way, York, ME 03909 (207)-351-6752
I, First Name Last Name hereby agree to release and hold harmless Wilderness Way Wildlife (WWW), it's Directors and volunteers from any and all claims resulting either directly or indirectly from the rescue and transport of Species Found to WWW on Date . Please provide a phone number Area Code Phone Number and address Street Address Address Line 2 City State Zip you can be reached at as required by IF&W for our records.
I understand that the transfer of the animal above from my possession to WWW eliminates any future access to the animal(s) for testing purposes. This includes testing for diseases and parasites that are potentially fatal to humans and/or pets.

YesNo (ME IF&W must be contacted)
It is also my understanding that WWW may, at its sole discretion, release the animal(s) or otherwise transfer them at any time after execution of this document pursuant to the standards and practices of WWW without further notice to me.

YesNo (ME IF&W must be contacted)
By signing below, I represent to WWW that the above animal(s) have not caused a broken skin injury to myself or anyone else (including pets), nor did I or anyone else have direct contact with the animal's blood or saliva to the best of my knowledge.

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