I_____________________hereby requests the emergency quartering of the animal being evacuated because of a pending or occurring disaster.
The animal owners (agents) hereby release HPR, its volunteers, affiliates, partners, volunteer veterinarians, the person or entity who is receiving the animal (hereinafter “animal caregivers”) from any and all liability regarding the care and quartering of the animal during and following this emergency.
The animal owners (agents) acknowledge that if emergency conditions pose a threat to the safety of the animal, additional relocation may be necessary, and
this release is intended to extend to such relocation.
The animal owners (agents) acknowledge that the risk of injury, sickness or even death to the animal during an emergency cannot be eliminated and agree to be responsible for any veterinary expenses which may be incurred in the treatment of their animal.
It is also requested but not required that the animal owners (agents) contribute to the feeding and daily care of their animal, if possible.
The animal owners agree and understand herein, permanent surrendering means giving up all rights and ownership to my animal, and agree that my animal can be re-homed - put up for adoption immediately after HPR intake.
The animal owners agree and undestand herein, if an animal is not claimed within the agreed holding period (unless prior arrangements have been made), the animal will be then put up for adoption.
I agree and declare all information entered in this form is to be true and factual.
I gree and undertand that by submitting this form, I claim all responsiblity for the information contained herein.
I agree and undertand that by submitting this form my signature becomes a legal digital signature.
I agree of releasing all others harmless in their attempts to relay my emergency rescue request.