Text Box:

Animal Rescue Flights

 

Transport Request plus Liability Waiver

for Intrastate and Interstate Transport

 

 

 

By submitting this form as your request for transport, you are agreeing to:

 

All necessary paperwork for the animal(s) as well as the crate must be provided to the pilot upon departure of the flight or the flight will be cancelled. The safety and well-being of the animal during the transport is our top concern.

 

Sending Shelter or Rescue:

Contact Name:                                                                                                  Cell Phone:                                          

Organization:                                                                                                     Alternate Phone:                                   

Street, City, State, Zip:                                                                                       Email:                                                  

Alternate Contact Name/Cell Phone/Email:                                                                                                                     

Shelter/Rescue URL:                                                                                                                                                     

Is the sending organization is a 501(c)3?               If so, please provide the name and email address of the person to contact for a “letter of acknowledgment” of the pilot’s donation (fuel costs, aircraft rental costs, etc.) so that these costs can be tax-deductible:                                                                                                                                                              

If different from above, please provide the name, cell phone number and organization of person delivering animal to origination airport:                                                                                                                                                 

                                               

Transport Animal’s Veterinarian:

Contact Name:                                                                                                  Work Phone:                                        

Organization:                                                                                                     Emergency Phone:                               

Street Address:                                                                                                 Email:                                                  

City, State, Zip:                                                                                                 Fax:                                                     

Alternate Contact Name/Cell Phone/Email:                                                                                                                     

Rescue URL:                                                                                                                                                                

 

Receiving Rescue:

Contact Name:                                                                                                  Cell Phone:                                          

Organization:                                                                                                     Alternate Phone:                                   

Street, City, State, Zip:                                                                                       Email:                                                  

Alternate Contact Name/Cell Phone/Email:                                                                                                                     

Rescue URL:                                                                                                                                                                

Is the receiving organization is a 501(c)3?                         If so, please provide the name and email address of the person to contact for a “letter of acknowledgment” of the pilot’s donation (fuel costs, aircraft rental costs, etc.) so that these costs can be tax-deductible:                                                                                                                                                  

Name, cell phone number and organization of person receiving animal(s) at destination airport, if different from above:                                                                                                                                                                                    

 

If ARF is delivering to a Forever Home, please fill out the following:

Was a home visit conducted?                                                     Was a vet contacted as a reference?                              

Has it been determined that the household is appropriate for the dog with respect to children present, level of activity provided, past pet experience, ability to provide for pet’s medical / nutritional needs, and accommodations for the pet?                                                                                                                                                                                                

 

General Information Needed for Transport Requests:

Crate Dimensions:                                                                     Desired Transport Date:                                     

Origin City/State:                                                                       Destination City/State:                                                  

Name of Animal:                                                                        Breed and Sex:                                                             

Weight of Animal:                                                                      Age of Animal:                                                              

Behavior issues?                                                                        Crate-trained?                                                               

Other Important Information?                                                                                                                                          

 

Medical Information for Transport

 

Micro chipped?              Yes                  No                    Do Not Know                 If Yes, Give Number:                             

Spayed or Neutered?      Yes                  No                    (Required unless veterinarian note included)

Health Certificate?          Yes                  No                    Date:                                                                                       

Rabies Vaccination?      Yes                  No                    Date:                                           (required if 3 months or older)

Puppy 1st Shots:            Yes                  No                    Do Not Know                 Date Given:                                          

Puppy 2nd Shots:            Yes                  No                    Do Not Know                 Date Given:                                          

Puppy 3rd Shots:            Yes                  No                    Do Not Know                 Date Given:                                          

Parvo/Distemper:           Yes                  No                    Do Not Know                 Date Given:                                          

Bordatella:                     Yes                  No                    Do Not Know                 Date Given:                                          

Heartworm Test:            Yes                  No                    Do Not Know                 Date of Test:                                         

Test Results:                                                                 Date Last Pill Given:                              

Allergies:                       Yes                  No                    Do Not Know                 Type:                                                   

Fecal test for worms:      Yes                  No                                Do Not Know                 Date:                                                   

Test Results:                                                                                                                            

If Feline: FIV test:          Yes                  No                   Date:                            Results:                                               

 

Our Concern about Sick or Infected Animals: READ CAREFULLY

 

Animal Rescue Flights (ARF) insists that an animal be free of all illness and has not been in the presence of a contagious disease or, if an illness or exposure is present, that ARF is made fully aware of the illness prior to arranging or performing transport. Transportation of an infected animal can result in a plane being contaminated and make the plane unsuitable for animal transport for periods up to one year. Any individual or organization that knowingly provides an ill/infected animal for transport will be liable for the cost of any decontamination that is required to make the plane suitable for transport and will be permanently barred from transporting animals by ARF. If an animal is transported and you later become aware that the animal was ill, infected, or exposed to a disease that is contagious to animals or humans, you must contact ARF immediately and provide all available information including veterinary contacts. Failure to provide this information will permanently bar the individual and the organization that individual represents from transporting animals by ARF. The cost of decontamination of the airplane will be born by the individual releasing for transport. By providing an animal for transport, you and the organization you represent are automatically agreeing to comply with the statements in this section on Ill/Infected animals. If you do not agree with these statements and/or are unwilling or unable to comply, then do not submit an animal for transport. If transport is for medical reasons or animal has a medical condition then the following are required: 1) Veterinary information, veterinary health certificate and copies of all medical records, 2) Description of medical condition, 3) Medicines animal must take / Directions for administering: Careful and complete veterinary labels on all medicines transported giving name of animal and veterinarian prescribing along with dosage to be given and name of medicine, 4) Short description of any potential behavior or information which you feel is important for the transport/handling of the animal (Aggression, Shyness, Fears, etc).

 

Liability Waiver for Shelters and Rescues Sending Animals for Transport

 

I, the undersigned, understand that Animal Rescue Flights (ARF) is a volunteer organization voluntarily providing free air transportation by privately owned or rented aircraft for special need rescue animals and are not financially reimbursed for the expenses of the flights. I, the undersigned, agree to waive and do waive and release Animal Rescue Flights, its officers, directors or other volunteers from any and all claims including, but not limited to, liability for negligence, any personal injury or property damage that might be suffered, and any wrongful death actions which an estate might bring, arising out of injury during any ARF flight or activity. It is understood and acknowledged that my signing of this Waiver of Liability is bound and effective for any and all ARF flights or activities. I further understand that the pilot in command (PIC) of any ARF flight has the final decision concerning the cancellation of the flight due to weather, mechanical problems or for any reason whatsoever, if in their judgment the flight can not be completed in a safe manner. I also understand that all animals must be transported in appropriate kennels and/or cages and must be accompanied by all required paperwork. Kennels and cages are to be provided for transport unless otherwise advised by a representative of ARF.

 

I, the undersigned, do herby certify that I am legally able to release the above named/described animal and all of its documents for transport to the receiving entity. I furthermore, understand and give authority to Animal Rescue Flights to determine if any changes must be made in the transport for flight or animal safety and to make such changes. Should the animal become ill during transport or any question concerning the health of the animal in Animal Rescue Flights care during a transport arise, the pilot has the authority to make decisions regarding whether the animal will be taken to the nearest veterinary facility (emergency landing) or whether the flight will continue to its next fueling or overnight destination where veterinary care will be instituted. If an animal’s health or condition is questioned by the pilot at any time, transport will continue only after a veterinarian has determined that continued transport will in no way endanger the animal, pilot or airplane. Should such a decision be made by the pilot, the animal will not be released to any person until the veterinarian certifies that the animal is healthy and that the reason for the need for veterinary care is corrected. I, the responsible person releasing the animal for transport, understand that I or the organization I represent are responsible for all veterinary costs that result from the pilot’s decision to seek veterinary consultation and care for the animal in transport. I will be contacted should this occur by an ARF representative after the animal is receiving veterinary care. I forever release Animal Rescue Flights, its agents, pilots or anyone involved in the transport of this animal from all liability for transporting and caring for this animal and from any liability resulting from previous actions of the animal/or agents.

 

I,                                                                      , (responsible party), release for transport the animal described above to the designated ARF pilot at a time and place mutually agreed upon by the parties. At the destination airport, this animal is to be released to                                                                                                                   (name of person or shelter).

 

Signature:                                                                                                                                  Date:                          

 

Printed Name:                                                                                                                                                              

 

 

Please scan and email this completed form to Help@AnimalRescueFlights.org   

 

 

(This section will be completed upon delivery of the animal to the destination airport)

 

Release of the Animal at Destination

 

I,                                                                      a representative of                                                                                 

 

received                                                            at                                                                      Airport on                    

 

Signature:                                                                                                                                  Date: