TNR Clinic Scheduling

If you register for clinic, You must confirm when prompted via email or text. If you confirm that you are participating but DO NOT attend trap handout and have not cancelled via text or phone you will no longer be able to participate in our clinics. *

Type Agree in Box Above

All cats that participate in our program are strictly outdoor cats. All residents that register live in Shelby County, KY. All cats will come to our clinics in the traps we loan to you. All cats will receive an ear tip of the left ear and a tattoo at the surgical site. Please sign here that you Agree to all conditions. Signature*

Date-Today's Date *

Date

First Name *

First Name Last Name

Phone Number *

Area Code Phone Number

Street Address *

Street Address

City *

Street Address

Street Address Line 2

City

Zipcode *

Street Address

Street Address Line 2

Postal / Zip Code

Email *

example@example.com

# of Cats Expected To Trap? *

This will be the number of traps you need subject to availability

Approximately how many of the cats are females if known?

Are any of these cat(s) nursing mothers? *

Select From Dropdown

Are any of these cat(s) currently pregnant to your knowledge? *

Select From Dropdown

Have any of these cat(s) received Topical Flea Treatment and if so when was the last application? *

Ex. Yes 02/20/20 or No, Type Response

Do you have any tame kittens that you wish to rehome if we have available rescue?

Yes No

If so how many kittens

Do you have any tame adult cats that you wish to rehome if we have available rescue?

Yes No

If so how many adults

Are you physically able to trap and transport (Cannot be place in an open bed truck or in a trunk of a vehicle)? *

Please select how you will you be paying the $35 per cat (please select the box). If you are not able to pay $35 per cat please select "NO". *

CASH CHECK MADE PAYABLE TO: OCKI CREDIT/DEBIT CARD NO

If you cannot afford $35 per cat, realistically what can you afford to pay per cat?

Please select amount from drop down list

Please select any assistance you receive and have your cards/documents available. No one will be turned away due to their inability to pay. We just need to know ahead of time so we can advertise for sponsorship.

Food Stamp Card Medical Card WIC Voucher Disability SSI Unemployment Income under Poverty level

Are you in need of food to feed the cats? If so we may be able to assist.

Yes No Maybe

Are you willing or able to sponsor the spay or neuter of another cat that someone else cannot afford to donate toward?

Yes No

Operation Catsnip of Kentucky, Inc.

Trap Loan Agreement

By my signature below, I am in receipt of traps loaned to me by Operation CatSnip of Kentucky, Inc. I acknowledge and agree to the following:

Operation Catsnip of Kentucky, Inc. is loaning the trap(s) to me. I agree to return the traps to the specified location on the date and time specified.

The value of each trap is $75.00 (plus shipping and tax). I am responsible for the full amount plus any costs of collection fees and attorney’s fees necessary to secure return or replacement of the loaned trap(s) if it is lost, stolen, or damaged.

I will return each trap clean or a $10.00 cleaning fee will be charged per trap.

For late returns, a late fee of 10% per day after the return date specified will be charged.

I will not use the trap to capture any owned cat, or to commit any other unlawful act, but only to capture cats, known to be un-owned or barn cats, and only for the purpose of spay/neuter procedures or other medically necessary treatment. I agree that any cats trapped, unless it is deemed medically inappropriate, shall be released in a lawful manner. Under no circumstances shall these traps be used to capture an animal for destruction or surrender to any animal control agencies. I will indemnify Operation Catsnip of Kentucky, Inc. and its members from any liability based on misuse of the trap.

I will transport or arrange for transport of said cats to the clinic as directed and will adhere to all its rules and instructions pertaining thereto.

Operation Catsnip of Kentucky Waiver Release From Liability Form

I hereby consent and authorize the veterinarians employed by Operation Catsnip of Kentucky’s Spay/Neuter Clinic to receive, prescribe for, treat, and surgically spay or neuter my cat(s). I understand that there are inherent risks related to the use of anesthetic and surgical procedures. Although all reasonable precautions will be taken, this is not a full-service veterinary facility and I assume all risks. I waive and release any and all claims for losses and damages I may have against the Shelby County Humane Society Mary Gaylord McClean Clinic, the city of Shelbyville, the county of Shelby, Operation Catsnip of Kentucky, and any and all veterinarians employed by all listed as well as the injury of any kind to my cat(s), including death.

If I do not pick up my cat(s) at the designated time of discharge, the cat(s) will be considered abandoned. Charges will be filed for abandonment. Doing so does not relieve me from paying all costs incurred by the individuals and organizations listed above that are associated with my cat(s), including boarding costs at not less than $50 per day. I understand that the Shelby County Humane Society Mary Gaylord McClean Clinic, Operation Catsnip of Kentucky, the volunteers, the veterinarians employed, and the officers, directors, and employees of these aforementioned organizations, the city of Shelbyville, and the county of Shelby, are not responsible for any post-surgical complications and treatment thereof for my cat(s).

After surgery, for at least 24 hours, I will confine my cat(s) in a quiet area away from children and other animals. Cat(s) will be kept inside their traps and in a temperature controlled environment when feasible. Adult cat(s) will be fed a small amount of food and water 4 hours post surgery or when they are capable of fully standing. Kitten(s) must be fed as soon as they are moving around and not stumbling so they do not sugar crash.

If you agree to these terms and conditions sign your full name below electronically.

Signature *

Signature means you Agree with the Terms & Conditions of the Waiver Release Liability AND Trap Loan out Clear

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