Coopers Chance Foster a Pet Application

Cooper's Chance Animal Rescue

Foster A Pet Application
Thank you for your interest in fostering a rescued pet. We have many ways you can foster, and we always allow a trial run before deciding to foster any pet. Cooper's Chance provides all supplies, food, and vet care; you give a safe and comfortable home. Together we help rescued pets find forever families.

The process is easy, begins with this short questionnaire so we can find the right fit for your home. A Team Member will contact you to discuss foster pets and answer any questions you may have.
Date*

MonthDayYear
Date
Name of the dog you are interested in:*
Referred By

Applicant Information
Applicant's full name:*
Co-Applicant's full name (if living in same household as Applicant):*
If there is only one applicant please type N/A
Street Address:*
City, State, Zip*
Major Cross Streets
Applicant's Phone:*

Area CodePhone Number
Co-Applicant's Phone:

Area CodePhone Number
Applicant's E-mail:*
Co-Applicants E-mail:
Applicant's Employer:*
Co-Applicant's Employer:

Pet Foster Information

Give details for your foster needs.
When can you start to foster a pet?
Date you can accept pets
Which foster program are you interested in?

Foster A PetDoggie Day Out - Just the daySlumber Pawty - WeekendMedical / Hospice
How long can you foster a pet in your home?
2 weeks, 30 days, 6 months, etc
What I'm looking for in a foster pet:
Gender, breed, temperment, age, etc.
Do you have a fully fenced yard?*

YesNo
Do you agree to keep the pet indoors?*

YesNo

Household Information
Are there other pets in the home? *

YesNo
Breed, Age, Gender of Current Pets
What other pets have you had, how long did you have them, and were they with you their entire life?
Do you have children who live with you or visit frequently?*

YesNo
Ages of children
Do you own or rent?*

OwnRent
Renters must provide a copy of written permission to complete adoption.
Additional notes you would like us to know

By signing this application, you agree to the following terms:

I/we agree that any dog I/we foster must reside within my/our home and cannot be tethered or tied in confined spaces. I/we agree to assume full responsibility for caring for this dog. In contrast, in foster care , agree to provide care for the animal(s), including food, water, and shelter, and to administer supplied medications as required.

I/we agree the dog must be kept from being abandoned, sold, or given to any other party or, in any other manner, be transferred to different ownership. CCAR reserves the right to remove and reclaim a dog at any time.

I/we agree not to abuse or neglect the dog, will notify the rescue of any health concerns, and commit to only using training with positive enforcement.

I/we will keep a collar with identification tags on the animal when outdoors and will notify the rescue if the animal becomes lost.

I/we declare that there are no representations about the dog's nature or any representation regarding the nature and extent of legal liability or financial responsibility that have caused me/us to make this release and indemnity agreement. Furthermore, I/we agree that CCAR and its representatives bear no responsibility for any damage costs or expenses liquidated or otherwise incurred resulting from fostering or adopting, Including but not limited to damage or injury to persons or property by the dog while in my care or any other person's care. I/we release, indemnify, and hold CCAR harmless from all liability of any nature and cause directly or indirectly relating to this placement.

I/we agree that CCAR does not represent or guarantee the dog's present or future medical condition, behavior, or temperament. I/we understand that any dog may be prone to medical or genetic conditions not readily evident at intake, and accept this animal “as-is.” I/we acknowledge that CCAR is not making any guarantees, expressed or implied, regarding health, fitness, or temperament. I/we agree to assume full responsibility for the veterinary care of this dog, including maintaining vaccinations as required by law.

I/we understand the rescue agrees to provide, at our cost, the foster pet with necessary veterinarian medical care administered by an authorized provider and basic pet care supplies. I understand that I need to arrange for any veterinary care services through CCAR in advance should the need arise. I acknowledge that CCAR will not reimburse me for veterinary services not explicitly authorized. CCAR will not be responsible for costs incurred by foster negligence,
I/we agree that should it be necessary for CCAR to take legal actions to recover the dog or otherwise enforce provisions in this agreement, I/we agree to pay all court costs and legal fees. If the terms of this contract are breached, I/we agree to pay CCAR liquidated damages.

Any changes or additional terms to these Terms and Conditions of Adoption document must be in the form of an Addendum and signed by all parties if any provision of this document becomes void or unenforceable by force or operation of law. The other provisions shall remain valid and enforceable.

I/we attest that the information provided on the application is true and accurate to the best of my/our knowledge.

I hereby RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO HOLD RESPONSIBLE Cooper’s Chance Animal Rescue from any liability, claims, demands, actions, including court costs and attorney fees, and causes of action whatsoever arising out of or related to any loss, damage, or injury, including death, I may sustain that, or any of the property belonging to me. I VOLUNTARILY ASSUME FULL RESPONSIBILITY FOR ANY RISKS OF LOSS, PROPERTY DAMAGE OR PERSONAL INJURY, INCLUDING DEATH, that I may sustain, or any loss or damage of property owned by me, as a result of adopting, WHETHER CAUSED BY THE NEGLIGENCE OF RELEASEES OR OTHERWISE.

I understand this is a legal and binding contract, and I agree to all of the terms herein by my signature.
Applicant Signature*

Clear
Date*

MonthDayYear
Date
Co Applicant Signature

Clear
Date

MonthDayYear
Date
Should be Empty:

Cooper's Chance Animal Rescue

Applicant Information

Pet Foster Information

Household Information