Foster Liability Waiver

I/we understand that all work performed with Moseleys’ Mutt Oasis Dog Rescue (MMO) is voluntary and at my/our own risk, and therefore, release MMO, its director(s),affiliate(s), and representative(s) of any and all public liability, property damages and/or medical costs incurred while I/we are providing fostering services for MMO. I/we do herby on behalf of myself/ourselves, heirs, administrators and assigns, irrevocably and unconditionally release and agree to hold harmless MMO, its director(s), affiliate(s), and representative(s) from any and all known or unknown,anticipated or unanticipated, suspected or unsuspected and/or fixed,conditional or contingent actions, causes of action, charges, suits, debts,expenses, including and without limitation, attorney’s fees, or damages,including but not limited to any medical costs, damages or property, person(s),or other pet(s) of any kind, nature and description at law or in equity, inconnection with or arising from my/our voluntary services performed with MMO. I/we understand that a home visit might be required prior to volunteering/fostering, and that Moseleys’ Mutt Oasis Dog Rescue may, at its discretion, make follow-up visits to ascertain if my home continues to meet the requirements of a volunteer/foster. Furthermore,MMO may excuse me/us from services at any time, for any reason at all, as my service is voluntary and subject to sole discretion of MMO. By signing this document, I acknowledge that I have read and understand and agree to ALL of the provisionsset forth in this contract and I further agree to abide by all of its terms andprovisions, completely.

Name

First NameLast Name

Email

example@example.com

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Signature

Printed Name

Date

* Facebook will be the primary method of communication, if this does not work please tell us the best way to get in touch with you.

Name

First NameLast Name

Facebook Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email

example@example.com

Phone Number

Please enter a valid phone number.

Driver's license #

I certify that I am at least 18 years of age:

Why do you want to foster a rescue animal(s) ?

Special considerations, request, or preferencesyou have in fostering a rescue animal(s)?

Animal(s) willbe kept:

When not home, where will animal be kept?

Where will animals sleep?

Is your backyard fenced?

Type of fence?

Height of fence?

Do you have a doggie door?

Do you have a crate?

Do you have an X pen?

Do you have a swimming pool?

Is your pool fenced?

Is your gate secured with a lock?

Have you had an animal contract Parvo in the last 6 months?

If yes, do you currently reside at the same residence?

Do you agree to keep current license and I.D.tag(s) on animals always ?

Do you agree to NEVER allow foster animal(s) to ride in the back of an open vehicleun-kenneled?

Do you agree to obey all leash laws?

Do you agree to NEVER take foster animal(s) to ANYdog parks?

Do you agree to NEVER allow strange or unknown animal(s) to meet nose to nose withyour foster?

We will teach you the proper way to introduce a dog if you do not know how to be safe with introduction. Safety of all animals is extremely important.

How many adults live in your home?

How many children live in your home?

Ages of children

How many pets you currently own and/or have in your home:

Breed, age, gender

Your Veterinarian’s Name:

Phone #

Address

Can you provide proof your pet(s) is/are currenton all required vaccinations?

Can you provide proof that your pet (s) arespayed/neutered, if required?

Do youown your home or rent your home?

How long have you lived there?

If you rent, do you have permission from your landlord to foster?

What type of home do you live in?

Landlord Name and Phone #

I agree that the animal(s) placed in my care is/are the property of MMO Dog Rescue and will be treated as such. I will be responsible for the animal while in my possession. I agree to do no harm to the animal(s) while in my care, and further agree to seek medical attention, when appropriate, if the animal(s) become sick or injured. I agree to contact Moseleys’ Mutt Oasis Dog Rescue immediately if the animal requires medical care/attention, or if I am unsure. Additionally, I agree to give any/all medications to the animal(s) while in my care, as necessary and/or required, if the animal(s) is/are being treated under veterinary instruction. I attest that all answers above are true to the best of my knowledge. If any of the information given above is found to be untrue or falsified, I understand that my foster application will be denied, and that I can be removed as a foster at any time either before or after I begin fostering for Moseleys’ Mutt Oasis Dog Rescue for any reason. I agree to surrender the animal(s), including all property that I may have in my possession belonging to Moseleys’ Mutt Oasis Dog Rescue representative immediately, upon request.

Signature

Printed Name

First NameLast Name

Date