Foster Home Caregiver Application – together-furever.org

Caregiver Information

We need a little information about you to help us better place pets that fit your lifestyle. Please complete the form to the best of your ability. The more information we have, the better we can place pets safely.

Today's Date

Name *

First

Last

Email *

Phone *

Best contact number to reach you in case of emergency

Mailing Address

Address Line 1

City

State

Zip Code

Birth Date *

You must be at least 19 years old

Have you ever fostered a pet before? *

Yes
No

If you answered yes, what rescue/shelter did you foster for?

Do you own or rent your home?

Own
Rent

Landlord or Leasing Agent Name

First

Last

Name of Apartment Complex

Landlord or Office phone number

Check which apply:

My landlord is aware of my fostering and is ok with pets on the property.
I would like Together Furever to contact landlord for approval.

Caregiver History

Have you, a family member, or any person living in the home where the animal will be fostered ever been convicted of any animal related misdemeanor or felony offense?

Yes
No

A background check may be done so please be honest.

Foster Home Information

Please note, to foster kittens and/or adult cats you must have a separate room in which to keep them.

Do you have a separate room for cats? *

Yes
No

Do you have a fenced yard? *

Yes
No

Dogs are the ONLY animal permitted outside during foster care stay. This is for the safety of the pet.

How tall is the fence?

Please list all Names and Ages of people living or frequent the foster property.

This is for the safety of your family as well as the pet. Some pets do better with older or no kids in the home.

What type of animal are you interested in fostering? Check all that apply:

Check all that apply:

Kid friendly
Cat Friendly
Dog Friendly

Resident Animals

Please list all animals living in the home. *

Please include type of animal, breed, age, spayed/neutered etc

Are resident animals up to date on all vaccines? *

Yes
No
I don’t know

Veterinarian Information

We use this information to receive vaccine records from your vet.

Veternarian Clinic Name *

Veternarian Name *

First

Last

Medications *

I WILL administer medication as needed to foster pet
I DO NOT want to administer medication to foster pet

Waiver of Liability

Waiver of Liability I, the undersigned, acknowledge my desire to provide a foster home for the animal detailed above (the “Foster Animal”) which are owned and/or for which Together Furever (“TF”) is entrusted with caring for. I understand by executing this Agreement that TF is granting me permission to keep, protect, feed, and care for the Foster Animal, and I attest that I have the requisite experience and expertise, and that I am knowledgeable in handling and care of the particular animal(s) entrusted in my care. I understand that there are inherent risks associated with handling and caring for the Foster Animal, including, but not limited to, the risk of personal injury resulting from animal bites, scratches, medical conditions, or disease. With such understanding, I agree for myself, my heirs, personal representatives and assigns, to waive, release and forever discharge TF and any affiliated entity, managers, directors, agents, officers, employees, volunteers, or trainer of TF (“Releasees”), from any and all claims, demands, losses or damages relating to any injury, to me, my property, and any other third party or their property, including, but not limited to, death or injury caused or alleged to be caused, in whole or in part, by my actions or the actions of the Releasees, unless caused by Releasees willful or gross negligence. Furthermore, I agree for myself, personal representatives and assigns, to indemnify and hold harmless TF from any loss, claims, action, causes of action, or proceedings of any kind which may be initiated by myself or any other person or organization as a result of any damage or injury caused by the Foster Animal, including demands, judgments, costs, loss of services, expenses, or reimbursement of reasonable attorney’s fees. By providing a foster home for the Foster Animal in my care, I understand that their stay in my home is temporary, and I will return the Foster Animal to the Together Furever Foster Care Coordinator upon request by the TF. I understand and agree that the foster care of the Foster Animal does not create a property right in that animal, and the Foster Animal may be removed at any time by TF, with or without cause. I understand I will not take the Foster Animal to another veterinary office without permission from authorized personnel. Furthermore, I agree that I will pay for any unauthorized veterinary care and/or additional supplies deemed unnecessary by the TF. If there is a medical emergency, I will follow the protocol attached to this Agreement. I have read this Agreement, and understand that by signing it I give up substantial rights that I would otherwise have to recover damages for loss occasioned by the actions, including negligence of Releasees, and sign it voluntarily and without inducement.

Waiver of Liability *

I have read and understand the terms of contract and the terms are agreeable to me.

Signature *

Date