I hereby authorize the release of ALL medical records pertaining to the above listed bird(s) to representatives of this rescue. I hereby relinquish to Feathered Friends Sanctuary & Rescue Inc. the above listed bird(s) to be placed in the rescue adoption/placement program. I relinquish all claims to the above listed bird(s).

It is hereby agreed, by and between Surrenderer and Feathered Friends Sanctuary & Rescue, Inc. (FFSR) as follows:

1) The Surrenderer is no longer able to keep/interested in keeping the bird described above.

2) The Surrenderer knows of no other person who has any claim to the above bird.

3) The Surrenderer hereby relinquishes, in favor of FFSR, all rights, title, and interest to and in this bird(s), along with any cage(s), toys, or other items concurrently surrendered. This grant is immediate and absolute.

4) The Surrenderer may at any time prior to the execution of any Bird Adoption Contract between FFSR and a third party, apply to adopt the bird, subject to the same conditions and restrictions as an adoption to a third party.

5) It is the Surrenderer’s understanding that he/she is not entitled to any portion of any adoption fees or any other donation.

6) It is understood that the purpose of surrendering this bird, is that FFSR provide for the physical and psychological needs of the bird, and that the Surrenderer may not in any way question or interfere with FFSR in the care, treatment or placement of the bird.

I HAVE READ AND UNDERSTAND THE ABOVE AND REALIZE THAT IT CONSTITUTES A LEGAL AND BINDING CONTRACT.

I acknowledge that by typing my name below, I willingly and with full knowledge enter into this contract.