Foster Application

Individual or Couple *
Primary First Name *
Primary Last Name *
Primary Cell Phone (000-000-0000) * Please use the following format 248-555-1212
Home Phone (000-000-0000) Please use the following format 248-555-1212
Primary Email * Please make sure to enter this correctly, as this is the main way we will contact you
Secondary First Name *
Secondary Last Name *
Secondary Cell Phone *
Secondary Email
Street Address *
City *
State *
Zip Code *
Primary Person's Birth Date *
Employment Status *
If you are employed, please list employer name. If you chose "other" above, please explain:
Please list names and ages of ALL adults who live or frequently stay in your home. *
Please list names and ages of ALL children who live or regularly stay in the home. *
Is your residence: House/ apartment/ condo/ townhouse/ mobile home/ other? *
How long have you lived at this address? *
Do you own or rent your home? *
If you rent or do not own your home, does your landlord/ lease/ homeowner allow pets? Are there breed or size limits? *
If you do not own your home, please list homeowner/ landlord name and phone number. *
Please tell us why you would like to foster for us *
What types of pets would you be interested in fostering? (Check as many as you wish)
Do you have experience with any of the above choices? If so, please list what.
Have you ever or are you currently fostering for any other animal welfare organizations or rescue groups? If so, who, what, when and where? *
Is everyone in your household aware that you are planning to foster for us? *
Does anyone in your household have allergies to pets? If so, what type? *
When left alone, will this pet be left loose/ crated/ outside/ garage/ other? *
Where will this pet be kept during the day? *
Where will the pet sleep/ be kept at night? *
Is your yard completely and securely fenced? If so, what kind of fence and how tall? *
How would you handle destructive behavior or housetraining issues? *
What will you do if this animal bites, scratches or scares a family member or friend? *
Are you willing to take responsibility for this pet until it is able to be adopted or come back to Cat Tales? *
For what reason(s) would you consider returning/giving up the animal? *
Will you give us several days (or more) to find another appropriate foster home for this pet if you cannot continue fostering?
Have you ever sold a pet, given one away or turned one into a shelter? If yes, please explain the circumstances. *
Have you ever been convicted of abuse or neglect of a child or animal? If yes, please explain: *
Current Pet Info
How many pets do you currently own? *
Please list ALL other pets living at this address, including name, species (dog/cat/parrot/hamster/etc.), sex, age and breed/ mix/ size (for dogs). *
Are all cats and dogs in the household spayed/neutered? If any are not, please tell us which ones and explain why not.
Are all pets in the household current on their recommended yearly vaccinations? If any are not, please tell us which ones and explain why not.
Are all other pets at this address good with other animals? If not, what will you do if they don't get along?
Will you be willing and able to separate the foster animal(s) from your own pet(s) for quarantine, safety and introductions?
Please name ALL other pets you’ve owned in the last 5 years, and why you no longer have them. If they passed away, please state cause of death *
References
Current/ Past Veterinarian or Clinic Name * If you have never owned a pet please tell us where you would go.
Veterinarian's City and State * Again if you have never owned a pet, please list where you would go
Veterinarian's Phone Number *
Please list the name and contact information (telephone or email) of two personal references - NOT related to you or living in the same household. *
Foster Agreement Please carefully read the following and signify your agreement by signing below.
I am 18 years of age or older as of the date of execution of this agreement. I have read and understand the foregoing Foster Application and certify that the answers I have given are complete, true and not misleading in any way. I understand that omission of information and/or failure to answer all questions in the Foster Agreement truthfully can result in this application being denied. I understand and accept that if an omission or untruth in the Foster Application is discovered after a foster animal is in my possession Midwest Pet Refuge has the right to repossess any foster animal I have in my care at that time. Neither I or anyone currently residing at my residence has ever been found guilty of violating any law regarding cruelty to animals. I give Midwest Pet Refuge permission to investigate all information provided, as well as contact veterinarians, landlords, references and related officials. 1. Care of Foster Animal I agree to never harm or abuse the foster animal(s) in any manner. I agree to provide proper care for the foster animal(s), including the following: sufficient high quality food; indoor shelter; administering of any needed treatment for injury or illness, flea control, heartworm preventative and any other necessary medical treatments; all agreed upon training and behavioral assessments; and any other agreed upon items to keep the animal in good health and spirits and prepare it for adoption. I agree to keep foster animal(s) leashed or in a secured, fenced area while outside. I agree to not chain, tether or tie up a foster animal outdoors while unsupervised at any time. I agree to not keep any foster animal outdoors during extreme or inclement weather conditions that may pose a risk to the foster animal’s health or wellbeing. I may not place the foster animal in a residence of another individual unless I receive written permission from the organization. I understand that Midwest Pet Refuge reserves the right to inspect foster homes and foster pets at any time to ensure foster animal is properly cared for. I agree to give Midwest Pet Refuge at least 24 hours (and preferably one week) notice if I can no longer foster the animal(s) in accordance with this agreement, and understand that another foster must be found before they can be removed. I understand that if I ever cannot properly care for/ have to give up this animal, it must be timely returned to Midwest Pet Refuge. 2. Veterinary Care and Behavioral Issues I agree to notify Midwest Pet Refuge if the foster animal requires veterinary medical attention or has any behavioral or health problems. Midwest Pet Refuge reserves the exclusive right to determine the proper course of action to take upon such notification. Midwest Pet Refuge agrees to pay for approved vet care of the foster animal. I agree to schedule the spay or neuter appointment for the animal(s) in a timely manner and to transport the animal(s) to Portland Veterinary Clinic (or other approved veterinarian) when necessary. I agree to transport animal(s) to Cat Tales for vaccinations, microchip or visual inspections as needed. I agree to get approval from Midwest Pet Rescue prior to any vet visit besides the spay or neuter appointment. In the event of an emergency where the foster animal requires immediate veterinary medical care and I am unable to get timely approval, I agree to attempt to seek that care from the veterinarian(s) approved by Midwest Pet Refuge. If such veterinarian(s) are not available, I agree to attempt to contact Midwest Pet Refuge for approval, if reasonably possible, prior to seeking emergency veterinary services. 3. Death, Impoundment, or Loss of Foster Animal I agree to notify Midwest Pet Refuge immediately if the Foster Animal is lost, impounded by animal control, or dies while in the care of the Foster Parent. 4. Foster Travel/Absence I agree to return the foster animal to Midwest Pet Rescue when going on vacation, traveling out of town, or am otherwise absent from the foster home for an extended period of time unless I receive prior written permission from Midwest Pet Rescue of temporary, alternative caretaking arrangements during such period. If possible, I will provide Midwest Pet Refuge with seven days notice of my obligation to return the Foster Animal pursuant to this paragraph. 5. Marketing of Foster Animal for Adoption I agree to bring animal(s) to adoption events, meet and greets and for adoption when scheduled. I agree to provide Midwest Pet Refuge with clear pictures and personality descriptions of all foster animal(s) in my care to facilitate adoption. I hereby irrevocably permit, authorize, grant and license the Midwest Pet Rescue (including its officers, directors, employees, agents, contractors, successors, assigns, licensees and volunteers (collectively, its “Representatives”)), the right to publish, display, exhibit, transmit, broadcast, reproduce, record, photograph, digitize, modify, alter, edit, adapt, create derivative works, exploit, sell, rent, license, otherwise use, and permit others to use my image, likeness, appearance, and voice obtained in connection with my participation in Midwest Pet Rescue’s foster animal program, and all materials created by or on behalf of the organization that incorporate any of the foregoing (“Publicity Material”). I understand and agree that all such Publicity Materials are the sole property of the organization, and may be used by the organization in connection with promoting the mission of the organization without payment, royalties or any other consideration and without prior notification. 6. Ownership of Foster Animal I understand that Midwest Pet Refuge reserves complete control and ownership of all foster animals at all times, and can reclaim them at any time for any reason. Upon request, I agree to return foster animal(s) to Midwest Pet Refuge at any agreed upon date. I understand and agree that neither I nor any other person, including but not limited to my spouse, boyfriend, girlfriend or domestic partner, will have any ownership rights or interests of any kind in the foster animal; and that I have sole right and exclusive authority to place the animal in the custody of Midwest Pet Refuge. I am not permitted to keep, give away, sell, adopt out, rehome or dispose of foster animal(s) in any manner without express permission from Midwest Pet Refuge. I understand there is no guarantee or assurance that the foster animal(s) will be available for adoption by me at the end of the fostering period. If I refuse to timely return the foster animal to Midwest Pet Refuge upon request and/or notification, Midwest Pet Refuge has a right to enforce the provisions of this agreement and reclaim such foster animal(s). I agree that I am responsible for any and all costs incurred by Midwest Pet Refuge, including attorneys’ fees, in connection with its efforts to reclaim foster animal(s). If Midwest Refugee seeks recovery of foster animal in a court of law as a result of my refusal to return such foster animal, Midwest Pet Refuge is entitled to $500 in liquidated damages in addition to any expenses, fees and costs identified herein. 7. Compliance with Foster Agreement and Applicable Law I agree to comply with all of Midwest Pet Rescue’s policies, procedures, and requirements stated herein regarding the responsibilities of the foster parent. I agree to comply with all applicable state laws and regulations, as well as local or county ordinances. I agree to cooperate with the Midwest Pet Rescue as needed to comply with all responsibilities under state laws and regulations, as well as local or county ordinances. 8. Assumption of Risk and Liability Release and Waiver I understand that any animal, including the foster animal, may pose a risk of injury, death, illness or damage to me, my family, guests, other persons, other animals and/or to personal property. I voluntarily and knowingly assume any and all risks associated with my agreement to act as a foster parent under this Agreement, including the risk of injury, death, illness or damage. I hereby expressly waive and relinquish, completely release and forever discharge Midwest Pet Rescue and its representatives, including its officers, agents, employees and volunteers, from any and all claims, actions or causes of action of any kind whatsoever, which I now have or later may have against the organization and/or such representatives, and which in any way result from, arise out of or are in connection with my custody, care, or control of the foster animal, whether or not such claims, actions or causes of action may be attributable to the negligence or carelessness of the organization or such representatives. I understand that by signing this Agreement, I am waiving any and all claims of any kind whatsoever arising from the taking of custody of the animal against Midwest Pet Refuge, its officers, agents, employees and volunteers, including but not limited to claims of negligence, veterinary malpractice, conversion, breach of contract and/or personal injury. I agree, on behalf of myself and my heirs and representatives, to indemnify and hold harmless the organization and its Representatives, from and against any and all liability, claims, actions, suits, causes of action, losses, costs, expenses, attorneys’ fees and damages of any kind, whether in law, equity or otherwise, whether now known or unknown, suspected or unsuspected, arising out of or in any way related to this Foster Agreement or my fostering of the foster animal. 9. Miscellaneous This agreement shall be interpreted in accordance with the laws of the State of Indiana, without regard to principles of choice or conflicts of law, and I agree that all disputes relating to this Foster Agreement shall be resolved or adjudicated in the courts of Jay County, Indiana. If any provision of this Foster Agreement is deemed void, invalid or unenforceable, such provision shall be considered severed from this Foster Agreement and shall not affect the validity or enforceability of any other provision. The section headings contained in this Foster Agreement are for reference purposes only and shall not affect the meaning or interpretation of this agreement or any of its terms hereof. This Foster Agreement and any exhibits hereto constitute the entire understanding and agreement between the parties regarding the subject matter herein and supersedes all prior understandings, discussions, representations, warranties and agreements between the parties, whether written or oral. Any modifications to this Foster Agreement must be in writing to be enforceable.
Signature *

Check all entries for accuracy, then press the "Submit" button ONLY ONCE. If you do not receive a confirmation email after you hit Submit, please re-submit your application.

Foster Application

Current Pet Info

References

Foster Agreement

Please carefully read the following and signify your agreement by signing below.

1. Care of Foster Animal

2. Veterinary Care and Behavioral Issues

3. Death, Impoundment, or Loss of Foster Animal

4. Foster Travel/Absence

5. Marketing of Foster Animal for Adoption

6. Ownership of Foster Animal

7. Compliance with Foster Agreement and Applicable Law

8. Assumption of Risk and Liability Release and Waiver

9. Miscellaneous