Foster Application

Full Name*

First NameLast Name

E-mail*

Phone Number - Home

Area CodePhone Number

Co Applicant

Age

Phone Number - Cellular

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number - Work

Area CodePhone Number

Do you live in a:*

Do you:*

OwnRentLive with ParentsOther

If Renting: Please indicate landlord contact information

Household Setting

RuralSuburbanUrban

Describe your Homes Activity Level

Busy/NoisyModerate Comings/GoingsQuiet with Occasional Guests

Please List all People Living in the Household (Include Name, Relationship, Gender and Age)*

Does Anyone in your Household have Allergies to Animals?*

YesNo

Are all members of your Family agreeable to Fostering a Dog?*

YesNo

Please list your pets, age, shots, altered, special needs

Would you be willing to have a Hopes Haven Volunteer come to your house for a home check ?

YesNoOption3

Veterinarian Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number

Area CodePhone Number

Do you have a preference in sexe of foster?*

MaleFemaleNo Preference

Please describe the type of dog you are willing to foster (Please include breed, coat length, personality traits, energy level, hypoallergenic) We always want to make sure we have the best fit for our foster homes*

Are you willing to foster a dog of any age?*

YesNo

If not, what age would you consider?

What size dog are you willing to foster? (Check all that apply)*

SmallMediumLarge

Are you willing to take your foster dog to vet appointments at a convenient time for you?*

YesNo

If No please explain

Are you willing and able to medicate your foster, even if it just a monthly heartworm preventative?*

YesNo

We cannot guarantee a dog to be housebroken, are you equipped to train with love and patience?*

YesNo

Have you had any experience with with an emotionally or physically neglected or abused dog?*

YesNo

If Yes please explain

Are you willing to use a crate for a dog if recommended?*

YesNo

Do you have a fenced yard?*

YesNoPartial

If fenced, please give details on height, material, # of gates, are gates locked or lockable?

How many hours in a day would the foster be left alone?*

What are you plans to exercise your foster? Please list any parks near by or trails, how many walks a day, approximate length, activities such as agility*

By sending this electronically, I acknowledge that I have completely read this questionnaire and comprehend it fully.

I understand that applying does not ensure approval and that untruthful answers or failure to comply with the requirements of this application can result in the forfeiture of any Hopes Haven animal fostered by me.

I certify that the above information is correct, and I understand that the information will be verified.

I understand that by submitting this form electronically, I agree to release and covenant to hold harmless Hopes Haven Rescue and it's members from any claims, damages, costs, or actions incurred because of the care or actions of the foster dog.

I accept full responsibility for the dog(s) actions at all times, and release Hopes Haven Rescue from any liabilities or damages that may be incurred because of fostering such dog(s).

I agree that if I'm unable to foster the dog(s) anymore that I will return the dog(s) to Hopes Haven Rescue and try to give Hopes Haven Rescue a 2 week period to try and find another suitable foster for the dog(s).

I agree that I may not TRANSFER OWNERSHIPE OF ANY ANIMAL FOSTERED FROM HOPES HAVEN TO ANOTHER PARTY.

I understand that in handling animals there exists a risk of injury, infection, disease including physical harm caused by animals to me, my family or my pets. On behalf of myself, my heirs, personal representatives and executors, I hereby release, discharge, indemnify and hold harmless Hopes Haven, its agents, servants and board from any and all claims, causes of actions, or demands and any nature of cause including costs and attorney fees incurred or sustained by me in any way connected with my services to Hopes Haven but not limited to: animal bites, accidents, injuries, property damage and veterinary fees.

You must be over 21 years of age to foster or adopt from Hopes Haven Friends

Electronically signing below means I agree to provide temporary foster care for Hopes Haven and agree to the terms.

PLEASE READ CAREFULLY- HH Policy and Terms

I must comply with HH policies concerning this dog while the dog is still in temporary foster care.

I understand that the custody of this dog will be temporary until the dog is adopted by an approved applicant.
As a Temporary Foster Home, I agree to comply with the following conditions and requirements:

1.The dog is and shall remain the sole property of HH until an adoption is finalized. I understand that upon the request of the HH the dog shall be relinquished to HH within 24/48hrs.

2.I will provide the dog with good care, including but not limited to, proper food, fresh water, shelter, exercise, grooming, training and medication when required.

3.I will comply with these instructions received from HH and will not deviate from any instructions as to the care and maintenance of the dog without consulting with a representative of the HH.

4.I agree to maintain the animal as my own household pet and companion.

5.I agree to comply with all Oregon State laws and local ordinances applicable to the dog

6.I agree not to abandon, trade, give away, or sell the dog, nor is the dog to be used or sold for commercial use or research purposes. If I no longer desire or am unable to keep the dog within the terms of this agreement, the dog must be returned to HH. The dog is NEVER to be turned over to an animal shelter or passed to another owner.

7. I agree to keep the dog under my control and not let the dog roam freely outside of the home or fenced yard. Keeping the dog on a chain, rope, dog-run or similar device is not permitted.

8. I will provide a safe and loving home environment and will socialize the dog to humans and other dogs. Dogs are not to be excessively crated (not more than a total of4 hours in a 24 hour period).

9. I will provide basic training or reinforcement of proper house manners and obedience skills. This training and reinforcement will be done only by positive reinforcement. At no time will the foster home use punishment as a training tool.

10. I agree to properly supervise said dog always. I will be physically present when the dog is allowed outside during which time the dog will either be in a fenced area and/or leashed.

11. I agree to the following regarding veterinary care:
HH must approve all vet visits. Said visit must be with one of
HH’s approved vets. If FOSTER takes foster pet to an unapproved vet for any reason,FOSTER agrees to be responsible for all medical bills incurred as a result of said unapproved vet visit except in cases of emergency when the dog’s life may be in danger. HH will decide for spay/neuter surgery and I agree that I will take this dog to its spay/neuter appointment and for any other necessary veterinary care as directed by HH unless other arrangements have been made by agreement.
If the dog needs medical attention, a member of HH must be contacted

12. This agreement is not transferable. If I am unable to care for the dog I will immediately return the animal to the HH.

13. I give permission to HH to enter upon my premises at anytime upon reasonable notice for the purpose of determining whether or not I am complying with this Agreement, and to remove the dog in the event that I violate the terms of this Agreement.

14. I understand that other animals in my household could be exposed to medical or behavioral conditions that have not been recognized in the foster dog placed with me by HH, and that HH is not liable for any disease or injury of my own companion animals or other exposed animal.

15. I agree not to attempt to hold the HH responsible for any damages which the dog may do to any person or property. I specifically release HH of any responsibility pertaining to any damage to property or personal injury or any occurrence relating to the dog and shall hold HH harmless regarding any damage or injury(ies) of any nature whatsoever, and agree to notify HH immediately of any damages and/or injury(ies).

16. I agree to help coordinate with meet and greets for the HH foster dog. I understand that all potential adopters must complete an adoption application and a signed adoption contract provided be approved by a HH representative.

17. I recognize this is an Agreement and have signed this Agreement freely and voluntarily and by electronicaqlly submitting this form I agree to all terms listed.

Date*

MonthDayYearHourMinutesAM/PM Option

Your name*

Co-Applicant name (if applicable)