Relinquishment Form

PO BOX 84042
Los Angeles, CA 90073
FX 661-461-3115

Please complete the fields below and we will respond to your inquiry.

Sex:
Date Sex was Verifed: *
Parrots Name:
Parrots Sex:
Parrots Species:
Gaurdians First Name:
Gaurdians Last Name:
State Parrot is Living:
Street Address:
City:
Zip Code:	(5 digits)
State:
Daytime Phone:
Evening Phone:
Email:
Veterinarians Name:
Veterinarians Number:
Veterinarians Office:
Veterinarians Fax:
Is the bird hand tame? Please descibe:
Comments and Photo of the Parrot:	Enter comments here!
I, entering "yes" in the adjacent field, hereby donate to the Association for Parrot C.A.R.E., the above listed bird(s) to be placed in the PARROT C.A.R.E. sanctuary and release ALL medical records for the above listed bird(s) to authorized representatives of PARROT C.A.R.E.. I relinquish all claims to the above listed bird(s) once s/he has formed a flock at the sanctuary but not my right to visit him/her: