Release of Custody

Name:
Phone:( ) -
Address:

E-mail address:

DO YOU WISH US TO RELEASE YOUR CONTACT INFO TO APPROVED ADOPTOR UPON ADOPTION COMPLETION? (circle) YES NO

Date:

Type of reptile:

Name of animal:

Age:

 Sex:

 Reason for giving up:

 Where did you get it originally?

 How long have you owned this animal?

 Have you ever given up an animal before?
If yes, please explain.

Has this animal ever bitten anyone?
If yes, describe circumstances

 Has this animal had any type of medical attention? Please specify. 


Please state your Vet's name and location:

Disposition of animal: tame semi-tame aggressive

Describe the cage this animal has been in if it is not with the animal: 

Describe the diet and frequency of feeding of this animal. Please be as specific as possible: 


Describe the amount and frequency of handling of this animal:


I understand that by completing and signing this form that I acknowledge that I have legal rights to this animal, and am legally able to make decisions regarding its care. Furthermore, I give up all ownership and other rights to this animal. I understand that the Turtle Turds Reptile Rescue will try to place this animal in an approved home.

Turtle Turds Reptile Rescue relies on donations to maintain animals in its custody.  Please consider making a contribution to cover the costs of caring for this animal. Keep this in mind:  Some animals may take several weeks or months to place. We must care for them until then; your donations make this possible. Average cost of feeding and heating a reptile is $5-10/week.

Amount of donation:  $                        Thank you

Sign:_________________________________ Date:_______

* a copy of this will be printed out upon recieving this animal and a physical signature will be required.  A copy will be provided to you for you records.