Foster Application

Are you volunteering, fostering OR both?*

All potential foster homes are screened for suitable placement of animals. By submitting this application, you give permission to Houston Chow Chow Connection to investigate and confirm the information provided. All forms become the property of Houston Chow Chow Connection.

We reserve the right to refuse placement of an animal for any reason.

Must be at least 21 years of age to foster and show proof in the form of a driver’s license.

Name*

First Name Last Name

Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Home Phone*

Area Code Phone Number

Work Phone*

Area Code Phone Number

Cell Phone*

Area Code Phone Number

Email*

example@example.com

Driver's License No. & State*

Release for Veterinary Reference:(to be completed by potential foster if you have a current vet)

The undersigned hereby give permission for any veterinarian providing service to me to release medical information on any/all of my animals to Houston Chow Chow Connection.

Current Veterinarian*

Address*

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number*

Area Code Phone Number

Signature*

Clear

Have you fostered before? If no, skip next field.*

If yes, for which organization?*

What are your expectations?*

What responsibilities, if any, are you not willing to accept?*

Are you willing to commit to fostering the animal until it is adopted?*

Do you agree and understand that Houston Chow Chow Connection is unable to project how long the animal may need to be fostered?*

Do you agree and understand that adoption of your foster pet MUST go through Houston Chow Chow Connection adoption process and may not be placed solely by you?*

Do you agree and understand that if you do find a possible permanent home for your foster pet, you will contact Houston Chow Chow Connection so that we may contact the potential adopter?*

Do you agree and understand that if you decide that you want to adopt the foster pet, you will contact Houston Chow Chow Connection and you will complete the adoption process as any other adopter would?*

Do you agree and understand that if you want to adopt the foster pet, you must put Houston Chow Chow Connection on notice that you would like to adopt the foster pet before the rescue organization receives an application on the foster pet or notice by another potential adopter?*

Do you agree and understand that if Houston Chow Chow Connection has another potential adopter before the rescue organization has knowledge that you would like to adopt the foster pet, that you will return the foster pet to the rescue organization within 24 hours of demand if the adoption to another person/family is approved?*

Do you agree and understand that Houston Chow Chow Connection has the sole authority regarding the final disposition and placement of the foster pet?*

Are there other adults in your household? If no, skip next section.*

If yes, is each committed to becoming a foster family?

Are there children in your household? If no, skip next 2 sections.*

If yes, please give their ages:

Will any of your children be responsible for caring for your foster pet? If no, skip to next section.*

If yes, please explain what their level of care will be:

Is anyone in your household allergic to animals? If no, skip to next section.*

If yes, please explain:

Do you own or rent your property? *

For how long?

If you lease/rent, do you have permission from your landlord to have pets on the property? NOTE: If you do not lease/rent, skip next 5 sections.

Does your lease/rent require a pet deposit?

If so, has it been paid?

Are there any breed or weight restrictions?

Name of Manager or Landlord

Phone Number of Manager or Landlord

Area Code Phone Number

How many pets do you currently have in your household? Please provide the type, name, age, sex & breed of each:*

Are these pets spayed / neutered?*

Are they current on all vaccinations and on heartworm preventative?*

Are you able to keep the foster animal separated from your personal pets, if necessary?*

Do you have a fully fenced yard? If no, skip next section.*

If so, please state type and height of fence:

Does your yard have a covered patio area or other shaded area?*

Do you have a pool? If no, skip next section.*

If yes, is the pool fenced off?

Are there a lot of children in the neighborhood and/or are you frequently visited by children? If no, skip next 2 sections.*

If yes, do any of them have access to your yard/kennel/house when you are not home?

If yes, please indicate how you intend to prevent them from gaining access to the foster animal either intentionally or by accident:

Is anyone home during the day?*

How many hours a day (approximately) would the foster pet be alone?*

Where will the foster pet stay during the day?*

Where will the foster pet stay at night?*

Do you travel frequently? If no, skip next question.*

If yes, how often?

Where would the foster pet stay if you are traveling?*

HOLD HARMLESS / INDEMNIFICATION / RETURN OF FOSTER PET

HOUSTON CHOW CHOW CONNECTION (AND ITS OFFICERS, BOARD OF DIRECTORS, VOLUNTEERS, AFFILIATED ENTITIES, AND/OR AGENTS) SHALL NOT BE LIABLE TO VOLUNTEER AND/OR FOSTER ON ANY THEORY OF LEGAL LIABILITY INCLUDING BUT NOT LIMITED TO THE NEGLIGENCE OF HOUSTON CHOW CHOW CONNECTION (AND/OR ITS OFFICERS, BOARD OF DIRECTORS, VOLUNTEERS AND/OR AGENTS), FOR ANY INJURY, DEATH OR DAMAGE DIRECTLY OR INDIRECTLY CAUSED BY PET. VOLUNTEER AND/OR FOSTER DOES HEREBY RELEASE HOUSTON CHOW CHOW CONNECTION (AND ITS OFFICERS, BOARD OF DIRECTORS, VOLUNTEERS AND/OR AGENTS) FROM ANY AND ALL LIABILITY, CLAIMS, SUITS, OBLIGATIONS, DEMANDS, OR CAUSES OF ACTION, KNOWN OR UNKNOWN, FORESEEN OR UNFORESEEN, ARISING OUT OF OR RELATING IN ANY WAY TO PET OR HOUSTON CHOW CHOW CONNECTION’S RELEASE OF PET TO VOLUNTEER AND/OR FOSTER. IT IS THE EXPRESSED INTENTION OF VOLUNTEER AND/OR FOSTER AND HOUSTON CHOW CHOW CONNECTION THAT THE RELEASE PROVIDED FOR IN THIS PARAGRAPH IS DESIGNED AND INTENDED TO PROTECT HOUSTON CHOW CHOW CONNECTION (AND ITS OFFICERS, BOARD OF DIRECTORS, VOLUNTEERS, AND/OR AGENTS) FROM ANY PERSONAL INJURY CLAIMS BY VOLUNTEER AND/OR FOSTER OR OTHERS AND FROM THE CONSEQUENCES OF ANY HARM, BEHAVIOR, OR OTHER ACTION BY PET, AND FROM THE CONSEQUENCES OF ANY ACT OR OMISSION OR NEGLIGENCE ON THE PART OF HOUSTON CHOW CHOW CONNECTION (AND ITS OFFICERS, BOARD OF DIRECTORS, VOLUNTEERS AND/OR AGENTS) IN TRANSPORTING A PET, IN OBTAINING CUSTODY OF PET, IN PROVIDING CARE FOR PET, IN TRAINING OR NOT TRAINING PET, OR IN FAILING TO PROVIDE TIMELY OR ADEQUATE WARNING TO ANY PERSON CONCERNING PET. IF FOSTERING, I AGREE TO RETURN THE FOSTER PET WITHIN 24 HOURS OF DEMAND TO HOUSTON CHOW CHOW CONNECTION AND IF I FAIL TO RETURN THE DOG TIMELY I AM LIABLE FOR $1500.00 IN LIQUIDATED DAMAGES AND ANY ATTORNEY FEES AND OTHER COSTS THAT HOUSTON CHOW CHOW CONNECTION MAY INCUR IN GETTING THEIR FOSTER PET RETURNED TO THE RESCUE ORGANIZATION. VOLUNTEER AND/OR FOSTER AGREES THAT ANY DISPUTES REGARDING THIS CONTRACT WILL BE DECIDED IN HARRIS COUNTY, TEXAS.

My signature below affirms that I have read and agree to all the above conditions:

Signature of Volunteer/Foster (1):*

Clear

Signature of Volunteer/Foster (2):

Clear

Date*

Date

Volunteer / Foster Application