Foster Application

Dog being fostered (if known)

Date

Name*

First NameLast Name

If your name on Facebook is different from the name above, what is your name on Facebook?

This helps us associate messages with your application.

Are you over the age of 21

YesNo

Your Date of Birth*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Home Phone Number

Area CodePhone Number

Cell Phone Number

Area CodePhone Number

Work Phone Number

Area CodePhone Number

Email*

example@example.com

Do You Own or Rent*

OwnRent

If you rent, are animals allowed

YesNo

If there are restrictions on animals (weight or breed), please explain

If you rent or reside in another person's home, please provide their name and phone numbers

Number of adults in the house*

Number of children in the house *

Ages of children*

Do you have a yard?*

YesNo

Is the yard completely fenced?*

YesNo

Type of fence

Please select all of the below that describe your normal day*

Home all dayOut part-timeGone 7 - 10 Hrs daily

Please indicate pets currently living with you. If none mark N/A or NONE.

	Name	Sex	Breed/Species	Length of time owned	Are they Altered?
Dogs
Cats
Birds
Others

Name of you veterinarian*

Are your pets?*

Indoor onlyIndoor with just going out to use the restroom and playOutdoor only

Are your pets current on their vaccinations?*

YesNo

Are all of your dogs spayed or neutered?*

YesNoOther

What type of dogs would you like to foster?

How long are you willing to foster at any one time?

Are you willing to foster more than one dog at a time?

YesNoOther

Where will the animal be kept during the day?*

Where will the animal be kept during the night?*

Do you have sago palms in your yard?*

YesNo

Have you cared for young, un-weaned puppies before?

YesNo

Have you ever given medication to a sick animal before?

YesNo

If yes please explain

Are you willing to provide food and basic needs (excluding vetting and medications) at your own cost?

YesNo

Have you ever fostered an animal before

YesNo

If yes, which organization did you foster for?

I agree to provide a Cypress Lucky Mutt Rescue (CLMR) representative access to all parts of my home and property for a home inspection before my application to foster is approved.

I understand that I may be required to provide foster care to my foster animal for an extended and indefinite period of time.

I represent that I am over 21 years of age.

I understand that Cypress Lucky Mutt Rescue provides no guarantee as to the health of my foster animal and that my foster animal may have medical needs, socialization problems, and may not be housebroken.

I agree to provide my foster animal with veterinary care as authorized by Cypress Lucky Mutt Rescue, and I will not arrange or pay for any elective veterinary care for my foster animal without the express consent of an authorized Cypress Lucky Mutt representative. I understand if i authorize any vet care not authorized by a CLMR representative, CLMR is under no obligation to reimburse me or pay for that care.

I will take all necessary precautions to prevent my foster animal from either impregnating another animal or becoming impregnated. In the event that happens, I will notify Cypress Lucky Mutt Rescue immediately.

I understand that I may only have my foster animal temporarily.

I agree that I am fostering this animal for Cypress Lucky Mutt Rescue, and that I do not have any right of ownership over my foster animal. I further agree that Cypress Lucky Mutt Rescue’s rights in and to my foster animal are superior to mine.

I agree to provide a Cypress Lucky Mutt Rescue representative access to my home and property to check on the welfare my foster animal at any time that I am in possession of my foster animal.

I agree to immediately return any foster animal in my care to Cypress Lucky Mutt Rescue at the request of CLMR authorized representative at any time and for any reason. If Cypress Lucky Mutt Rescue is forced to undertake legal action to enforce this provision of the agreement, I agree to indemnify Cypress Lucky Mutt Rescue for all court costs and attorney fees connected with such an action.

If I am planning to move at any time during the period when I am housing a foster animal, I agree to contact Cypress Lucky Mutt Rescue prior to my move and provide Cypress Lucky Mutt Rescue with my new contact information. I understand that Cypress Lucky Mutt Rescue has the right to request return of my foster animal based on my change of residence, and I agree that I will surrender my foster animal to Cypress Lucky Mutt Rescue immediately upon request.

If at any point I can no longer, or I no longer want to, continue to provide care and shelter for my foster animal, I agree to contact Cypress Lucky Mutt Rescue as soon as possible. I understand that moving a foster animal may take time, and I agree to continue to care for the foster dog until such arrangements can be made.

I will not transfer possession or custody of my foster animal to any other person at any time other than to a representative of Cypress Lucky Mutt Rescue or with CLMR representative's express consent, except for temporary, short-term possession for the purpose of vet care, grooming, etc.

I agree to contact my Cypress Lucky Mutt Rescue case manager with any and all questions or concerns about my foster animal or the Foster Care Program as well as with updated contact information.

I agree to contact my CLMR case manager immediately should my foster animal show any sign of illness or if my foster animal is involved in any sort of accident regardless of whether or not visible injury results.

I agree that if I refuse or fail to comply with any provision of this agreement, Cypress Lucky Mutt Rescue has the right to terminate this agreement and also has the right to the immediate surrender and return of my foster animal(s). I further consent to provide Cypress Lucky Mutt Rescue access to my premises if necessary to facilitate the return.

I agree that the opportunity given to me to help rehabilitate my foster animal is of significant benefit to me, and serves as proper legal consideration in exchange for my agreement to the terms of this contract. I have read this application and Agreement in its entirety, and I agree that all statements and agreements contained in this document are made by me and are truthful, under penalty of perjury under the laws of the State of Texas.

I make the above statements and voluntarily enter into this agreement to provide a temporary home as a foster caregiver to any animals Cypress Lucky Mutt Rescue may temporarily place in my care.

Signature