EmailMe Form - FOSTER HOME APPLICATION/CONTRACT

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Phone

### - ### - ####

Email

Please list the names & ages of all the humans in your household

Why do you want to foster?

Have you ever surrendered a pet to a shelter/rescue group? If so, please explain.

HOME INFORMATION:

Property where the foster animal will be kept

Address

City, State, Zip

Is property owned?

Yes

No

If renting, please provide landlord's contact information
(name, address, city/state/zip, phone number)

Is your yard fenced?

Yes

No

If so, please describe size of yard, height and fencing material used.

If not, how do you plan on handling potty breaks and exercise for your foster dog?

GENERAL QUESTIONS:

Where will the foster pet spend most of his/her time?

Approximately how many hours per day will the foster pet be alone?

Where will the foster pet be kept when no one is home?

How did you hear about PAWS of NE LA?

Are you familiar with the use of a crate to confine your foster pet during your absence or at night?

Yes

No

Is everyone in the family committed to fostering a pet?

Yes

No

How long are you willing to foster?

What types of animals are you able to foster? (Preferred size, age, breed, etc.)

PETS OWNED OR CARED FOR BY THE APPLICANT:

Please complete the following for each animal in your care.

Name each pet owned or cared for by you.

List age of each pet owned or cared for by you.

List the sex & if that animal has been spayed or neutered for each pet owned or cared for by you.

Name of Veterinarian.

List the date & product used of the last heartworm preventative medicine given to the pets owned or cared for by you.

List the date & product used of the last flea/tick preventative medicine given to the pets owned or cared for by you.

List the date & type of the last vaccinations given to the pets owned or cared for by you.

Release Statement *

Agree

Foster Parent shall not hold PAWS of NE LA liable, or responsible for, and PAWS of NE LA shall be saved and held harmless from and against any and all claims and damages of every kind, for injury to any person or persons, and for damage to or loss of property arising out of or attributed to, directly or indirectly, the operation or performance of PAWS of NE LA and any of its Board Members, Officers, Fosters, Volunteers or members under this agreement, including claims and damages arising in whole or in part from the negligence of PAWS of NE LA.

Foster Parent Hereby releases PAWS of NE LA and all its Board Members, Officers, Fosters, Volunteers and any other members or Representatives from any and all responsibility with regard to Fostering, which the Foster Parent undertakes voluntarily and with full knowledge of the above release and its implications.

Foster Dog(s) is not to be transferred from the Foster Parent to any other party without prior approval from PAWS of NE LA.

Foster Dog(s) shall never be abandoned, sold, given away or turned over to a shelter.

Foster Parent will notify PAWS of NE LA of any contact changes (address, phone number, email) within 24 hours of change.

Foster Parent will notify PAWS of NE LA immediately if Foster Dog(s) gets loose and is missing.

Foster Dog(s) remains the property of PAWS of NE LA while in Foster care.

I certify that I have read and understand the terms of this Release Statement by checking the box above.

I certify that all information listed above is true. I acknowledge that I have read and understand the terms of this Foster Contract and Release Statement by typing my name below. This agreement holds binding for any and all future dogs fostered for PAWS of NE LA, even if there is a hiatus between fostering.

Signature *

Date of submission *

MM / DD / YYYY