I, the undersigned, hereby declare and confirm that I am willingly surrendering the following animal and equipment, as described in the attached form, to The Lizard Lighthouse Inc (hereinafter referred to as "the Organization"). I understand and agree to the terms and conditions outlined below:

1. Surrender of Animal and Equipment:

   I acknowledge and confirm that I am surrendering the animal and equipment described in the attached form to the Organization. I understand that by surrendering the animal and equipment, I am transferring all rights and responsibilities associated with them to the Organization.

2. Accuracy of Information:

   I warrant and represent that all information provided in the attached form is true, accurate, and complete to the best of my knowledge. I understand that the Organization relies on the accuracy of this information for the proper care and handling of the surrendered animal.

3. Waiver of Claims:

   I hereby release and discharge the Organization, its directors, officers, employees, volunteers, and agents from any and all claims, demands, actions, causes of action, or liability arising out of or in connection with the surrender of the animal and equipment. I understand that the Organization will make reasonable efforts to care for and rehome the animal, but there is no guarantee or warranty regarding the outcome or success of such efforts.

4. Indemnification:

   I agree to indemnify and hold the Organization harmless from any and all claims, damages, liabilities, costs, or expenses (including legal fees) incurred as a result of any inaccuracies or misrepresentations made by me in the attached form or any breach of this consent disclaimer.

5. No Right of Return:

   I understand that once the animal and equipment have been surrendered to the Organization, I have no right to reclaim or demand their return. I acknowledge that the Organization has sole discretion over the future of the animal, including but not limited to adoption, placement, or euthanasia, in accordance with their established policies and procedures.

6. Governing Law:

   This consent disclaimer shall be governed by and construed in accordance with the laws of the jurisdiction where the Organization is located.

7. Travel Fee

   I understand there will be a $20 travel/surrender fee if I am unwilling or unable to meet a Lighthouse Team Member within 25 miles of their location.

By signing this consent disclaimer, I affirm that I have read and understood the terms and conditions stated above, and I voluntarily and knowingly consent to surrender the animal and equipment to The Lizard Lighthouse Inc.