TLC Rescue: Dog Adoption Application

Name of the dog you want to foster. If unavailable put N/A.

Foster's Name

First & Last Name

Address

Street Address

Street Address Line 2

CityState

Zip Code

E-mail

Phone Number

Area CodePhone Number

Phone Type

Names and ages of all permanent residents of your home (adults/children)

Do you currently have any pets?

If you currently have pets, please list them below.

Are your current pets altered?

If your current pets are not altered, please explain why below.

Vet reference (please call your vet and give permission to release information to us)

Vet name, address & phone number

Two Personal References

When will you be ready to foster this dog?

Is anyone in your home allergic to dogs?

Does anyone in your home fear dogs?

Are you familiar with dog regulations in your area?

If you answered no to the question above, please contact your town/county/condo assoc and ask them what the regulations are.

I/We live in a

Do you rent or own this property?

Renters, have you contacted your landlord to find out if there's any restrictions on the kind or size of dog you can have?

Approximate square footage of your home

Do you have a yard?

If vertical fence, what is your fence height?

Do you work outside the home?

If you both work outside the home, how many hours per day are you away?

How many hours per day will this dog be alone? Please explain.

Have you discussed fostering with all members of your household?

Based on the description in the dog's bio, do you feel pretty confident that you will be likely to foster this dog upon meeting it?

What activity/energy level do you prefer?

Other

Two references

Do you have any additional comments, questions or concerns? Anything else you would like us to know to help match you up to a dog?

I understand that completing this application does not guarantee I will be allowed to foster a dog, and that the application is a tool to help Caring Heart Dog Rescue determine if this dog and my family are a good fit for each other. I acknowledge that all information provided on this form is true and correct. I understand that any misrepresentations may result in my not being approved and/or removal of the adopted dog from my possession. I also certify that I have never been convicted of animal cruelty or neglect.

I agree to allow a representative from Caring Hearts Dog Rescue to contact my vet for a reference.

I also acknowledge that the foster dog is a foster dog unless I choose to adopt it. By signing this document, I also agree that I will not change the medical records from Caring Hearts Dog Rescue to my own name while fostering it.

Caring Hearts Dog Rescue does not guarantee this animal in any way as to health, performance, behavior, or bloodline. As such, Caring Hearts Dog Rescue is unaware of the medical, genetic, or behavioral history of the animals in our facility. The shelter will advise of any known or observed medical or behavioral issues and will make our best determination as to animal breed mix and age.

When an animal arrives at Caring Hearts Dog Rescue we perform an evaluation, examination and administer initial vaccinations as necessary to jumpstart the animal’s immune system (if vaccinations are required) and protect the health of other animals in our facility. However, it is possible that an animal could be incubating illness or disease, and vaccines would not protect them.

Rescue animals should be seen by our selected practice Veterinarian.

I agree to comply with all City, County, and State codes regarding the care, sheltering, sterilization, and fostering of animals

I acknowledge that all information provided on this form is true and correct. I understand that any misrepresentations may result in my not being approved and/or removal of the dog(s) from my possession. I also certify that I have never been convicted of animal cruelty or neglect.

I agree to allow a representative from Caring Hearts Dog Rescue to contact my vet for a reference.

I agree that if for some reason I am unable to care for the dog(s), that I will contact Caring Hearts Dog Rescue so that they can take back the dog.

I also agree and understand that spaying and neutering for puppies is the responsibility of Caring Hearts Dog Rescue and that they will help facitiilate the process.

By signing this argreement, you also irrevocably, agree as follows:

1. To indemnify and save and hold harmless Caring Hearts Dog Rescue from and for, any and all liability, claims, suits, proceedings, demands, losses, damages or expense of any name or nature, including administrative orders and proceeding and arbitration, which Caring Hearts Dog Rescue sustains or incurs, including all claims regarding property loss, personal injury or death, resulting in any way, or in any manner connected with your fostering of dog(s) hereinafter referred to as “PET(s)”.

2. You assume full risk of any loss, injury or damages whatsoever occurring caused by or related directly or indirectly to PET(s) upon or after transfer of PET(s) to your foster care.

3. This right of indemnity shall include attorney fees and any and all civil or administrative defense costs as incurred.

4. This Agreement is also a covenant not to sue Caring Hearts Dog Rescue for any cause or matter referred to herein and you agree that the provisions contained herein are intended to be as broad and inclusive as permitted by laws of State of Wisconsin and Texas and if any portion hereof is held invalid,
it is agreed that the balance shall, notwithstanding, continue in full force and legal effect.

Please read the above, check this box, sign, and click Submit.

Signature

Signature date

I understand that completing this application does not guarantee I will be allowed to foster a dog, and that the application is a tool to help Caring Heart Dog Rescue determine if this dog and my family are a good fit for each other. I acknowledge that all information provided on this form is true and correct. I understand that any misrepresentations may result in my not being approved and/or removal of the adopted dog from my possession. I also certify that I have never been convicted of animal cruelty or neglect.

I agree to allow a representative from Caring Hearts Dog Rescue to contact my vet for a reference.

Foster Application