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Pampered Parrots Avian Rescue
PO Box 1644 Airway Heights, WA 99001
509-218-3438
Relinquish Form
Date:_______________________
Name of Bird______________ Species _________________________ Band # (if present) __________
Gender M F (DNA Sexed Surgical Sexing Laid eggs )
Approximate Age _________ Hatch Date (if known) ______________
Name of Owner(s) ______________________________________________________________________
Address ______________________________________________________________________________
City, State, Zip Code ____________________________________________________________________
Telephone (H) ___________________________ (W)_____________________________
E-Mail________________________________________________________________________________
Reason for giving up your bird_____________________________________________________________
How did you hear about Pampered Parrots?
______________________________________________________________________________________________
By signing this Relinquishment Agreement you transfer ownership (The term “you” as used in this agreement applies
to anyone signing this agreement as a relinquishing owner) of the bird described above, and any included accessories,
to Pampered Parrots Avian Rescue, hereafter referred to as PPAR. You also give release of any and all veterinary
records pertaining to the relinquished bird. It would be appreciated if you can have a copy of any veterinary records
submitted at the time of your relinquish.
You acknowledge your understanding that the relinquishment of the above bird does not qualify as a tax-deductible
donation. However, as PPAR is designated by the Internal Revenue Service as a 501(c)3charitable organization,
donations of cages, accessories, etc. may qualify.
Would you like to request a receipt? YES NO If yes, what items are you donating and what is their value? Please
be aware that we will only issue a receipt for Fair Market Value of item(s). If you donate an item with a value over
$500.00, be sure to get an appraisal. The IRS may reject your deduction if you do not have an appraisal.
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
You warrant that you are the sole owner of the above bird, having the right to transfer its ownership, and that there are
no encumbrances on or other ownership interests to the bird.
PPAR will not sell or breed this bird or allow its adoption to anyone that will. PPAR will exercise due diligence in
screening and selecting potential adopting families in an effort to find the best possible home for this bird. You
acknowledge and agree that in relinquishing this bird, you give up any right to participate in the adoption process. We
keep adopting and relinquishing families confidential.
You acknowledge your understanding that PPAR does not grant visitations once this bird is relinquished. Prior to any
subsequent adoption PPAR will at times, intervals, and by means of it’s own choosing provide to you periodic updates
regarding this birds well being if you so request.
You agree to defend, indemnify, and hold harmless PPAR from and against all actions, claims, damages, losses, and
expenses (including reasonable attorneys fees) if any of the above warranties are incorrect or incomplete, or if you
breach this agreement. Washington state law will govern this agreement, and you agree that any litigation arising under
this agreement will be brought in a court having jurisdiction within Washington.
You agree, without additional consideration to sign, acknowledge, and deliver any other documents and take any other
action necessary or appropriate and reasonably requested in order to carry out the intent and purposes of this
agreement.
I have read this agreement, understand it, and agree to its terms.
______________________________________________________________________________________
Your Signature / Date
______________________________________________________________________________________
PPAR Representative Signature / Date
PO Box 1644 Airway Heights, WA 99001
509-218-3438
Relinquish Form
Date:_______________________
Name of Bird______________ Species _________________________ Band # (if present) __________
Gender M F (DNA Sexed Surgical Sexing Laid eggs )
Approximate Age _________ Hatch Date (if known) ______________
Name of Owner(s) ______________________________________________________________________
Address ______________________________________________________________________________
City, State, Zip Code ____________________________________________________________________
Telephone (H) ___________________________ (W)_____________________________
E-Mail________________________________________________________________________________
Reason for giving up your bird_____________________________________________________________
How did you hear about Pampered Parrots?
______________________________________________________________________________________________
By signing this Relinquishment Agreement you transfer ownership (The term “you” as used in this agreement applies
to anyone signing this agreement as a relinquishing owner) of the bird described above, and any included accessories,
to Pampered Parrots Avian Rescue, hereafter referred to as PPAR. You also give release of any and all veterinary
records pertaining to the relinquished bird. It would be appreciated if you can have a copy of any veterinary records
submitted at the time of your relinquish.
You acknowledge your understanding that the relinquishment of the above bird does not qualify as a tax-deductible
donation. However, as PPAR is designated by the Internal Revenue Service as a 501(c)3charitable organization,
donations of cages, accessories, etc. may qualify.
Would you like to request a receipt? YES NO If yes, what items are you donating and what is their value? Please
be aware that we will only issue a receipt for Fair Market Value of item(s). If you donate an item with a value over
$500.00, be sure to get an appraisal. The IRS may reject your deduction if you do not have an appraisal.
______________________________________________________________________________________________
______________________________________________________________________________________________
______________________________________________________________________________________________
You warrant that you are the sole owner of the above bird, having the right to transfer its ownership, and that there are
no encumbrances on or other ownership interests to the bird.
PPAR will not sell or breed this bird or allow its adoption to anyone that will. PPAR will exercise due diligence in
screening and selecting potential adopting families in an effort to find the best possible home for this bird. You
acknowledge and agree that in relinquishing this bird, you give up any right to participate in the adoption process. We
keep adopting and relinquishing families confidential.
You acknowledge your understanding that PPAR does not grant visitations once this bird is relinquished. Prior to any
subsequent adoption PPAR will at times, intervals, and by means of it’s own choosing provide to you periodic updates
regarding this birds well being if you so request.
You agree to defend, indemnify, and hold harmless PPAR from and against all actions, claims, damages, losses, and
expenses (including reasonable attorneys fees) if any of the above warranties are incorrect or incomplete, or if you
breach this agreement. Washington state law will govern this agreement, and you agree that any litigation arising under
this agreement will be brought in a court having jurisdiction within Washington.
You agree, without additional consideration to sign, acknowledge, and deliver any other documents and take any other
action necessary or appropriate and reasonably requested in order to carry out the intent and purposes of this
agreement.
I have read this agreement, understand it, and agree to its terms.
______________________________________________________________________________________
Your Signature / Date
______________________________________________________________________________________
PPAR Representative Signature / Date
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