Foster Care Application and AgreementGet a Jump on the Process and Start the Applications Today!RM_StatsFirst Name *Last Name *Today's DateEmail *Address State or RegionALAKAZARAAAEAPCACOCTDEDCFLGAHIIDILINIAKSKYLAMEMDMAMIMNMSMOMTNENVNHNJNMNYNCNDOHOKORPARISCSDTNTXUTVTVAWAWVWIWY Phone Number (Numbers Only)Please enter numbers only. No - or .Other Contact InformationDo You: Own RentLandlordLandlord's Phone Number (Numbers Only)Please enter numbers only. No - or .Please list the names and ages of your other household members.Member #1Member #2Member #3Member #4Do you have any other animals in the home? Yes NoIf yes, Please list animals type and age:Are your other animals up to date on Vaccines? Yes NoAre your other animals altered? Yes NoDo you have a fenced yard? Yes NoType of animal you are interested in fostering: Dog Puppy Cat Kitten OtherPlease explain why you would like to Foster for Verde Valley Humane Society:Have you fostered before? Yes NoIf Yes, for whom and when?Do you have time to house train? Yes NoDo you have experience in animal bottle feeding? Yes NoDo you have any medical training? Yes, Human Yes, Animal NoWhere will the foster animal generally be kept?Approximately how many hours will the foster animal be home alone?When you are away from home where will your foster animal be kept?Who is your Veterinarian?This agreement is between you (Hereinafter called “Foster Caregiver”) and Verde Valley Humane Society (Hereinafter called “Shelter”).Foster Caregiver acknowledges that he or she is NOT becoming the owner of any of said animals, but is only willing to provide humane care for any such animals and will return said animals upon said request of the Shelter.It is further agreed by and between the Shelter and Foster Caregiver as Follows:(Please read each paragraph and check the AGREE boxs to indicate your agreement each item.)1. *Yes, I AgreeFoster Caregiver agrees to let the Shelter inspect Foster Caregivers premises where the animal is being kept at any time to ascertain and satisfy itself that the animal is cared for.2. *Yes, I AgreeFoster Caregiver agrees not to alter in any way the appearance of the animal being fostered without written permission of the Shelter. This includes declawing, cropping of ears or tails, etc.3. *Yes, I AgreeFoster Caregiver agrees to provide adequate food, water, and shelter and kind treatment of animal at all times. In addition Foster Caregiver must adhere to all state and local animal laws. Foster Caregiver agrees to follow all additional written instructions from the shelter.4. *Yes, I AgreeFoster Caregiver agrees to notify Shelter of any behavioral or health issues of the animal. The Shelter reserves the exclusive right to determine the proper course of action to take upon such notification.5. *Yes, I AgreeFoster Caregiver is undertaking these obligations with no claim, now or in the future, to any type of compensation or reimbursement for caring for said animal.6. *Yes, I AgreeFoster Caregiver will notify the Shelter in the event of any change of address or phone number(s) listed. Foster Caregiver understands that he/she does not have any right or authority to keep the foster animal or place the animal in other homes or individuals unless permission is given in writing by the shelter.7. *Yes, I AgreeFoster Caregiver agrees that animal bites or other injuries to humans and other animals do occur, and agrees to hold harmless and indemnify, protect the shelter, from any claim or suit filed by anyone as a result of such incident. In addition, the Shelter will not be responsible if animal should damage or destroy property belonging to Foster Caregiver, or if animal transfers any disease or internal/external parasites to other animals belonging to foster caregiver.8. *Yes, I AgreeIf the Foster Caregiver wishes to adopt said animal, the Foster Caregiver must go though the adoption program screening process. The shelter deserves the right to determine final disposition of the animal.9. *Yes, I AgreeFoster Caregiver agrees to respect VVHS Euthanasia policy. Please direct any concerns to the Shelter Manager or Executive Director.This agreement is the entire agreement of the parties, and there are no oral or representations made in addition to this contract and it may only be changed in writing signed by both Shelter Manager and said Foster caregiver. %MINIFYHTML2830f6b794eb0a07a18b4907965b930746%%MINIFYHTML2830f6b794eb0a07a18b4907965b930747%%MINIFYHTML2830f6b794eb0a07a18b4907965b930748%Note: It looks like JavaScript is disabled in your browser. Some elements of this form may require JavaScript to work properly. If you have trouble submitting the form, try enabling JavaScript momentarily and resubmit. JavaScript settings are usually found in Browser Settings or Browser Developer menu.
