Magnolia Exotic Bird Sanctuary

Magnolia Exotic Bird Sanctuary

Magnolia Exotic Bird Sanctuary

501(c)3 Non-Profit Parrot Sanctuary

EIN 27-4734382

Relinquish Form

Date: ______

Name of Bird______Species______Band # (if present)

Note: If more than one bird please attach additional information on each bird

Gender M F Don’t know DNA Sexed Surgical Sexing Laid eggs

Approximate Age ______Hatch date if known ______

How did you acquire this bird?______

Duration of ownership______

Number of previous owners_____Please provide any details you have regarding previous owners/homes ______

______

Name of Owner(s) ______

Address______

City, State, Zip Code______

Phone (H)______Cell______

Email______

Reason for giving up your bird(s)______

Medical Information & Veterinary Name & Phone Number

Please provide copies of all medical records for each bird and a summary below:

How did you hear about Magnolia Exotic Bird Sanctuary?

______

  • Relinquishment fee: to be determined
  • Monthly life care auto payment amount: to be determined
  • The relinquished bird must come with its cage. The cage must be clean, in good condition and the appropriate size for the bird. If not provided as stated above you agree to purchase a cage deemed appropriate.
  • Through estate planning upon your passing we suggest leave a bequest in the name of your pet(s) to Magnolia Exotic Bird Sanctuary. If you are planning to make Magnolia Exotic Bird Sanctuary one of your beneficiaries, we encourage you to let us know. Prior notification enables us to better plan for the future of your parrot(s) and/or future projects.

By signing this relinquishment form you transfer ownership of the bird described above and any included accessories to Magnolia Exotic Bird Sanctuary. You also give release to any and all veterinary records pertaining to the relinquished bird(s). It would be appreciated if you can have a copy of any veterinary records submitted at the time of relinquishment.

You warrant that you are the sole owner of the above bird(s), having the right to transfer its ownership, and that there are no encumbrances on or other ownership interests to the bird(s).

MEBS will not sell or breed this bird.

You agree to defend, indemnify and hold harmless MEBS from and against all actions, claims, damages, losses and expenses (including reasonable attorney’s fees) if any of the above warranties are incorrect or incomplete or if you breach this agreement.

I have read this agreement, understand it, and agree to its terms.

Signature/Date

MEBS Representative/Date

______

Please return this form to:

Magnolia Exotic Bird Sanctuary

19703 Turtle Creek Lane

Magnolia, Texas 77355