I am the legal owner of the animal(s) that I am surrendering
—Please choose an option—YesNo

Your First Name

Your Last Name

Address

City

Province
—Please choose an option—ABBCMBNBNFLDNSNTNUONPEIQCSKYT

Postal Code

Your email

Your Home Phone

Your Cell Phone

Alt Email

___________________

What is/are your turtle(s) name(s)?

What type of turtle are you surrendering?
Cumberland SliderRed-Eared SliderYellow Belly SliderFlorida CooterPeninsula CooterFalse Map TurtleMississippi Map TurtleOuachita Map Turtle

Age of your turtle(s)

Gender of your turtle(s). Hold CTRL to select multiple options.
MaleFemale

Size of your turtle(s) in inches (please measure only the shell)

What does your turtle eat? What is the frequency and amount offered?

What is the reason you are looking to surrender your turtle? **If you are moving, please indicate your last day available at your current residence

What equipment are you able to donate along with your turtle? Please include dimensions of the aquarium

Veterinarian's Name and Phone Number

Is your pet(s) on any medication/vaccines now or in the past? If yes what were/are they?

Since there may be instances where a turtle is not fit for sanctuary life, do you agree to allow your pet to go up for private adoption instead. We will hold your pet out our shelter and find them a new home.
YesNo

You are aware of the admittance fee of $100 per turtle for acceptance into the sanctuary. This helps to fund the operation. Should you wish to donate more, all funds are graciously accepted.
YesNo

Declaration of Release

I hereby certify that I am the rightful guardian of the animal(s) who is/are the subject of this Sanctuary Application Form, hereinafter referred to as “the animal(s).” I hereby surrender any and all property rights to the animal(s) to Audrey’s Legacy.
I certify that no other person has a right of property to the animal(s). I have disclosed all material information regarding the medical and behavioral history of the animal(s). I understand that once I relinquish the animal, the animal will not be available to be returned and Audrey’s Legacy has no obligation to follow up with information about the animal(s).
I hereby release and forever discharge Audrey’s Legacy from any and all rights, claims, obligations, liabilities, and causes of action whatsoever arising out of or relating to the ownership, possession, or disposition of the Animal(s), and I agree to indemnify and hold harmless Audrey’s Legacy from and against any and all such rights, claims, obligations, liabilities, and causes of action which may be asserted by third parties.

I have fully read and understand this Surrender Agreement. I accept and agree to abide by its terms
—Please choose an option—YesNo

I certify that the information entered on this applicant is true. Enter your name and date below.

Is there anything else that you would like to tell us?