About the Dog You Wish to Foster
Dog’s ID Number (if known):
Breed you would not foster:
Desired sex: __Spayed Female __Neutered Male __No preference
Willing to foster: __ outgoing __ shy dog
__ dog that needs regular medication __dog that needs training
__ dog that needs grooming __ None of these
Name, Relationship, Phone:
Name, Relationship, Phone:
Please provide the name, phone number and address of your current veterinarian. If you no longer have a pet, please provide the name and phone number of the last veterinarian you did use. If this is your first pet, please list the name and phone number of the veterinarian you would like to use, should you be approved to adopt the dog.
***PLEASE CALL YOUR VETERINARIAN TO RELEASE INFORMATION TO CLEO’S KARMA RESCUE PRIOR TO SUBMITTING THIS FORM.***
Current pets (species/breed, age, temperament):
Do you have children or regularly visiting grandchildren? If so, what are their ages? Have they interacted with large or small dogs before?
Do you own your own home? If not, please list the name and telephone number of the homeowner/landlord.
What type of home do you live in: house, apartment, condominium, etc. Please describe your home to me. Do you have a yard; if so, is it fenced? Does your family live in an urban or rural setting?
How many hours a day will the dog be left home alone? When you are not home, where will the dog be (outside in pen, outside tied to run, outside in yard, inside free, inside enclosed in an area, or inside in a crate)?
What are the reasons behind your decision to foster a dog now?
If you have previously owned dogs or other pets, please let me know about them, and their current status (passed on, lost, given away, stolen, etc.).
Who do you believe will be mostly responsible for the care of the foster dog?
Please tell me how much training you are willing to do with your foster dog.
Where and how will the foster dog be exercised each day?
Do you agree to contact Cleo’s Karma Rescue in the event that your foster dog requires veterinary care?
What would you consider to be valid reasons for returning a foster dog to Cleo’s Karma Rescue?
THANK YOU FOR TAKING THE TIME TO COMPLETE THIS APPLICATION.
THE GOAL IS NOT TO BE INVASIVE, BUT TO PLACE EACH DOG IN THE MOST SUITABLE FOSTER HOME.
Thank you for your interest in helping us save a dog’s life.
VOLUNTARY RELEASE / WAIVER OF LIABILITY
This Voluntary Release/Waiver of Liability (the “Release”) is made and entered into by the undersigned, (_____________________________Foster’s name), effective as of the below-indicated date.
1. I acknowledge that, due to the unpredictable nature of animals, certain risks and dangers may occur while caring for an animal, including risks of injury to person and property, and that I have voluntarily agreed to make the foster contemplated herein with full knowledge of such risks and hereby voluntarily assume all of such risks.
2. I hereby voluntarily release, discharge, waive and relinquish any and all actions or causes of action for personal injury, property damage or wrongful death occurring to me or third parties as a result of any action or activity of any animal(s) fostered by me from Cleo’s Karma Canine Rescue Ltd., IT IS MY INTENTION BY THIS INSTRUMENT TO EXEMPT AND RELIEVE Cleo’s Karma Canine Rescue Ltd. FROM ALL LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR OTHERWISE.
3. I hereby agree to hold Cleo’s Karma Canine Rescue Ltd. harmless and defend and indemnity Cleo’s Karma Canine Rescue Ltd. from and against any liability, claims, judgments or expenses that may incur arising out of my fostering of the animal from Cleo’s Karma Canine Rescue Ltd. and/or my ownership or care of any such animal thereafter.
4. I HAVE CAREFULLY READ THE FOREGOING, AND I UNDERSTAND THAT TOGETHER THEY CONSTITUTE A DISCLAIMER OF LIABILITY AND A RELEASE OF ALL CLAIMS BY ME. I UNDERSTAND THAT I ASSUME ALL RISKS INHERENT IN MY DECISION TO FOSTER AN ANIMAL. I VOLUNTARILY SIGN BELOW TO EVIDENCE MY ACCEPTANCE OF THE ABOVE PROVISIONS.
5. If any portion of this Release is held invalid, it is agreed that the balance hereof shall continue in full legal force and effect.
6. This Release was executed at _______________________ (city), ___________________ (province) on ______________, 2012.
Foster(s) Signature(s) Krista LaFrenière, President
Cleo’s Karma Canine Rescue Ltd.
Interested in becoming a foster home? Fill out and submit the application below. The more homes we have, the more lives we can save!