Surrender Agreement

Electronically submit your surrender agreement form.

Name*
First Last
Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone
Email
Rabbit's Name*
Age of Rabbit
Sex*
- Male
- Female
- Unknown
Spayed/Neutered?*
- Yes
- No
- Unknown
Breed/ Appearance of Rabbit*
Where did you acquire this rabbit?*
How long have you had this rabbit?*
Why are you surrendering your rabbit?*
Does this rabbit have any medical concerns/history?
I authorize RBRR to obtain any/all medical records from our veterinarian.
Veterinarian's Name
Veterinarian's Phone Number
Signature
I ,(name stated above), am surrendering my rabbit, (name of rabbit stated above). I understand that my surrender of this animal companion is permanent and that the RBRR will assume full responsibility for this animal. I understand that foster care and placement into permanent, loving, indoor home may occur, if the animal is well enough to be placed. I release all interests in this animal when I surrender him/her to Red Barn Rabbit Rescue.
Electronic Signature*
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Signature