Foster Care Application/Agreement – Made a Promise Rescue (MPR)

Foster Care Application/Agreement – Made a Promise Rescue (MPR)

Apply to become a foster for Made a Promise Rescue. Please complete all sections and review the foster care agreement before submitting.
- Your Name*
  
  First NameLast Name
- Date of Birth
  
  MonthDayYear
- Your Email Address*
  example@example.com
- Your Phone Number*
  Please enter a valid phone number.
- Your Address*
  
  Street Address
  
  Street Address Line 2
  CityState / ProvincePostal / Zip Code
- PhoneEmailText MessageOther
- Your Occupation*
- How did you hear about us?*
- Please list up to 3 character references (Name and Phone Number)*
- Emergency Contact Name*
  
  First NameLast Name
- Emergency Contact Email*
  example@example.com
- Emergency Contact Phone Number*
  Please enter a valid phone number.
- Emergency Contact Address*
  
  Street Address
  
  Street Address Line 2
  CityState / ProvincePostal / Zip Code
- Relationship to You*
- AloneSpouse or PartnerParentsChildrenRelativeOther
- How many adults live in the home?*
- How many children live in the home?*
- Under 1 years old1-3 years old3-6 years old6-10 years old10-13 years old13-17 years oldN/A
- ApartmentDuplexHouseMobile HomeTown HomeCondoOther
- Very often - multiple times a weekOften - once a weekSometimes - once of twice a monthNot frequently - every few monthsVery infrequently - once or twice a yearNever
- Almost never1-3 hours4-8 hours9-12 hours> 12 hours
- YesNo
- Dog(s)Cat(s)Small animal(s)LivestockNoneOther
- If you have dog(s) please list the age(s), sex, breed(s), and if spayed/neutered:*
- YesNo
- When would you be able to start fostering?*
  
  MonthDayYear
  Date
- Dog's Day Out1-14 days (foster sitting)1-4 week(s) (temporary placement)General Foster Commitment (until dog is adopted)
- Bottle feed puppiesPregnant or nursing momsPuppies (up to 6mths)Teens (7-12mths)AdultsSeniorsMedicalHospice
- YesNo
- YesNo
- If you have fostered/volunteered for another shelter please share more information *
- Please share any additional information *
- Please read each statement carefully regarding our Foster Care Agreemnt and Foster Program. Checking each box indicates that you understand and agree to abide by each statement.
- I agree
- I agree
- I agree
- I agree
- I agree
- I agree
- I agree
- I agree
- I agree
- I agree
- I agree
- I agree that the animal(s) shall be provided the following: A) Reasonable exercise in a securely fenced yard appropriate for the animal(s), dog run, or on a leash. B) Chaining and tethering shall not be used as a primary means of confinement. C) The animal(s) shall be always under immediate control and protection of the Foster Parent and will not be permitted to roam outside of the fenced area or quarantine room.*
  
  I agree
- I agree
- I agree
- I agree to keep the foster animal indoors as a household pet and may not be kept outdoor. I further agree to provide proper care at all time, including adequate food, fresh water, and a safe environment that supports the animal's physical, mental, and emotional wellbeing. I agree to promptly notify Made a Promise Rescue of any medical concerns, changes in health, or veterinary needs. All medical care must be approved and coordinated by Made a Promise Rescue unless otherwise authorized in writing.*
  
  I agree
- I agree
- I agree
- I agree
- I agree
- I agree
- I understand that Made a Promise Rescue suggests that I keep animal(s) in a closed off area segregated from my current pets for a designated period of time in my care. There are risk that my pet(s) can get sick from the foster animal(s). I understand that Made a Promise Rescue cannot be held responsible for any illness that is passed along to owned pets. Made a Promise Rescue will not be held financially responsible for any vetting or medication that my pet may need.*
  
  I agree
- I agree
- I agree
- I agree
- I agree
- I agree
- I agree
- I agree
- I agree
- I agree to hold the Made a Promise Rescue harmless from any direct or consequential damages arising out of this foster care arrangement. I hereby accept this animal(s) and assume all the risks and responsibilities associated with this animal(s); including bites, and fully and completely release, indemnify and hold harmless, Made a Promise Rescue, its owners, directors, volunteers and agents from any claim, cause or action or liability or an sort of nature, whether, known or unknown, directly, or indirectly arising out of or in connection with animal(s) fostered.*
  
  I agree
- I agree
- I agree
- Signature (please sign below)*
- By signing, I certify that I have read and agree to all the above terms and conditions:
- Date Signed*
  
  MonthDayYear
  Date
- Should be Empty: