Revised 8/25/19
DANE COUNTY HUMANE SOCIETY’S WILDLIFE CENTER
RELEASE SITE APPLICATION
Land owner: _________________________________________________ Date of application: ___________________
Owner address: ___________________________________________________________________________________
City: _____________________________________________ State: _____________ Zip: _______________________
Property address (if different): _______________________________________________________________________
City: _____________________________________________ State: _____________ Zip: _______________________
Daytime phone: __________________________________ Evening phone: ___________________________________
Email address: ____________________________________________________________________________________
What is the primary use of your land?
What is the primary use of the land adjacent to the proposed release site?
Is hunting or trapping allowed on your property or an adjacent property? YES NO
If yes, please describe:
Do you or your neighbors have outside dogs or cats? YES NO
If yes, please describe:
Revised 8/25/19
Site Information:
Is there a water source on or near the property? YES NO
If so, is it available year round? YES NO
Please describe the water source:
Total acreage of land: _______________
Briefly describe the topography of your land along with percentage of each. (For example, wooded evergreen vs.
deciduous, grasslands, natural prairie, farmed crops, pasture, wetlands or bogs)
Species
Willing to have released
Have seen on property
Squirrels (gray, red, fox, flying)
Eastern cottontail rabbits
Chipmunks and ground squirrels
Water Birds (ducks, geese, gulls,
herons)
Sandhill cranes
Songbirds
Game birds (turkey, pheasant, quail,
etc.
Hawks
Owls
Large carnivores (fox, badger, coyote)
Small carnivores (mink, weasel)
Woodchucks
Opossum
Moles, voles, mice
Raccoons
Snakes
Turtles or amphibians
Are there any species you do not want released on your property? Please list below.
Would you be willing to allow temporary or permanent placement of nest boxes on your property? (Squirrels require the
use of a nest box for at least a couple weeks post release)
Would you be willing to provide supplemental food for the released animal for a couple weeks after it has been released?
Do you normally have any feeders out at your location, and if so, what kind?
Revised 8/25/19
Wildlife release times are coordinated based on many factors including the species most active time of day, weather
forecast, and availability of volunteers to transport the animal among other considerations. Having the flexibility to
release at a property with relatively short notice or without having to make contact with the landowner is a benefit to
getting the animal out as soon as they are able.
I must be notified in advance of releases on my property. YES NO
Animals can be released on my property without my presence. YES NO
Would you be willing to sponsor an animal to help cover the costs of rehabilitation if released on your
property? YES NO
Please read and sign below:
I, the undersigned, hereby agree to allow Dane County Humane Society’s Wildlife Center to relocate wildlife to the
property listed above. I am the owner of the above property and/or have authority over its use. I agree to accept all
animals indicated above as ‘willing to have released’ unless otherwise noted in this application. I understand that this
agreement does not promise that any animals will be relocated to my property. I give permission to Dane County Humane
Society’s Wildlife Center and all of its employees, interns, wildlife rehabilitators and volunteers to access my property for
the purpose of relocating wildlife on the listed property. Animals will continue to be relocated to the property unless I
contact Dane County Humane Society’s Wildlife Center and cancel this agreement. Dane County Humane Society’s
Wildlife Center employees, interns, wildlife rehabilitators or volunteers will not be held responsible for any wildlife
problems that may occur on the property or any buildings located on or near the property. I grant permission to relocate
without prior notice unless otherwise stated above. I agree to notify Dane County Humane Society’s Wildlife Center one
year in advance should we plan to allow hunting on said property. We will exclusively contact Dane County Humane
Society’s Wildlife Center if at any time the relocated or generated population of wildlife becomes a nuisance, hazard or
otherwise discontenting to the residents of the said property or neighboring properties. We give Dane County Humane
Society’s Wildlife Center permission to film animal releases for use online or television as long as the owner’s house,
name and address is not shown.
Land Owner’s Signature: ___________________________________________________ Date: _________________
Return completed application to:
Dane County Humane Society’s Wildlife Center
Mail: 5132 Voges Road, Madison, WI 53718
E-mail: wildlife@giveshelter.org
Fax: 608-838-0368
For DCHS use only:
Site evaluation notes
Acceptable release site: YES NO
For which species (approved above by landowner):
Evaluated by: Date: