Pitiful Pups Foster Application

Full Name*

First NameLast Name

Age*

E-mail*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number - Home*

Area CodePhone Number

Phone Number - Cellular*

Area CodePhone Number

Phone Number - Work*

Area CodePhone Number

Do you live in a:*

Do you:*

OwnRentLive with ParentsOther

If Renting: Please indicate landlord contact information

Household Setting*

RuralCity

Describe the Activity Level in your Home*

Busy/NoisyModerate Comings/GoingsQuiet with Occasional Guests

Please List all People Living in the Household (Include Name, Relationship, Gender and Age)*

Does Anyone in your Household have Allergies to Animals?*

YesNo

Are all members of your Family agreeable to Fostering a Dog?*

YesNo

Please List any Pets you have Living in your household (Please include Name, Breed, Age, Altered, Sex, UTD Vaccines, Heartworm)*

Veterinarian Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

Area CodePhone Number

Do you have a preference in the sex of foster?*

MaleFemaleNo Preference

Are you willing to foster a dog of any age?*

YesNo

If not, what age would you consider?*

What size dog are you willing to foster? (Check all that apply)*

SmallMediumLarge

Please describe the type of dog you are willing to foster (Please include breed, coat length, personality traits, energy level, hypoallergenic) We always want to make sure we have the best fit for our foster homes*

Are you willing to take your foster dog to vet appointments at a vet of our choice at a convenient time for you?*

YesNo

If No please explain

Are you willing and able to medicate your foster, even if it is just a monthly heartworm preventative?*

YesNo

We cannot guarantee a dog to be housebroken, are you equipped to train with love and patience?*

YesNo

Have you had any experience with with an emotionally or physically neglected or abused dog?*

YesNo

If Yes please explain

Are you willing to use a crate for a dog if recommended?*

YesNo

Do you have a fenced yard?*

YesNoPartial

If fenced, please give details on height, material, # of gates, are gates locked or lockable?

How many hours in a day would the foster be left alone?*

What are you plans to exercise your foster? Please list any parks near by or trails, how many walks a day, approximate length, activities such as agility*

I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the forfeiture of any Pitiful Pups, Inc. animal fostered by me.

I certify that the above information is correct, and I understand that the information will be verified.

I accept full responsibility for the dog(s) actions at all times, and release Pitiful Pups, Inc. for damages that may be incurred because of fostering such dog(s).

I agree to have Pitiful Pups, Inc. complete reference checks and conduct a home visit inspection to be able to approve my foster application if needed.

I acknowledge that I will be working with dogs whose temperments are not fully known

I state and agree that I have at least a basic understanding of handling dogs

I also understand that dogs may bite, scratch, or otherwise cause me harm, even if the dog is known to have a even temperment

I understand that dogs, especially ones that have been rescued and possibly abused and/or traumatized, can get easily startled, scared, feel threatened and may cause harm

I expressly assume the risk of any and all all injuries or damages I might incur relating to my dealings with the dog(s) rescued/takenin by Pitiful Pups, Inc.

I agree that if I'm unable to foster the dog(s) anymore that I will return the dog(s) to Pitiful Pups, Inc. and give Pitiful Pups, Inc. a 2 week period to try and find another suitable foster for the dog(s).

As a Foster Family for Pitiful Pups, Inc., I agree to fully release and hold harmless Pitiful Pups, Inc., it's board of directors, other fosters, volunteers and agents from any personal injury, property damages, claims, damages of any sort, expenses, causes of action, court costs and attorney's fees relating directly or indirectly to my assisting as a Volunteer or being a Foster Family to a dog for Pitiful Pups, Inc.

I declare and affirm that I am 18 years of age or older

I agree that if I have children, it is my responsibility to make sure that any dog(s) in my care from Pitiful Pups, Inc. is not left alone with the dog(s) and is supervised at all times. I agree to fully release Pitiful Pups, Inc., it's directors, board members, other fosters, volunteers and agents from any personal injury, damages, expenses, causes of action, court costs and attorney fees relating directly or indirectly that may occur to my child, family or others during my time of fostering &/or volunteering for Pitiful Pups, Inc.

I understand that by submitting this form electronically, I agree to release and covenant to hold harmless Pitiful Pups, it directors, agents and it's members from any claims, damages, costs, or actions incurred because of the care or actions of the foster dog.

Date*

MonthDayYearHourMinutesAM/PM Option

Full Name*

First NameLast Name

By signing below, I hereby acknowledge that I have completely read and fully understand. Do you agree to the above set terms?*

Signature*

Please verify that you are human*