FOSTER HOME APPLICATION

After you have read the description of our foster home program, please complete the questions below, sign, and return the application to CCR via email, fax, or regular mail. Thank you for your interest in our organization and we look forward to working with you!

Full name:
Address:
State:
City:
Zip Code:
Home Phone:
Cell phone:
E-mail:
Occupation:

Please list the name, age, and relationship of those persons residing with you.

Relatives:
Do you have nieces, nephews, grandchildren, neighborhood kids, etc. who visit often? Please explain:
Are there pets living in your household? Please describe each animal and list the species, age, sex, breed, and behavior characteristics of all animals. Are they neutered and current on all vaccinations including heart worm?:
Please describe your experience in training, rehabilitation, and any other activities involving dogs.:
Are you willing to train/rehabilitate a foster dog?:
What kind of exercise and activities will you provide a foster dog?:
Please describe the physical activity level of your home:
How many hours will your foster dog be left alone during the day?:
Where will the foster dog spend its time during the day and night and when left alone?:
Please describe your living arrangements. Do you live in a house, apartment, townhome, condo, duplex, or other?:
Do you have a yard? If so, is it fenced, what kind of fence, and what is the height?:
If you don’t have a yard, how will you accommodate for this?:
Do you own or rent your home?:
Would you accept a foster dog who requires medical care?:
Would you be willing and able to provide the care:
Would you accept a dog that has been abused or neglected?:
Would you accept a dog that has a physical handicap?:
Would you accept a dog that is not reliable with children?:
Would you accept a dog that is pregnant and will be whelping?:
Is there anything you feel CCR should know about you or your abilities to provide a foster home?:
The Foster Parent hereby declares that he/she is aware: a) That animals are different from human beings in their responses to human actions; b) That the actions of animals may be unpredictable; c) That an animal’s behavior may change after it leaves the shelter and accustoms itself to a home or other different environment; d) That the Colorado Canine Rescue makes no claims as to the temperament, health, or mental disposition of any animal put up for adoption The Foster parent acknowledges that he/she has received a copy of the Colorado Canine Rescue Animal Foster Home Policy and understands and agrees to all policies. GENERAL RELEASE OF LIABILITY, WAIVER OF CLAIMS, EXPRESS ASSUMPTION OF RISKS, AND HOLD HARMLESS AGREEMENT You, the foster family of the dog, and your estate, heirs, administrators, executors, and assigns, hereby release, forever discharge and hold harmless Colorado Canine Rescue, to include but not limited to owners, their heirs, employees, representatives, agents and volunteers (collectively called, the “RELEASEES”) from any and all liability and responsibility whatsoever, however caused, for any and all damages, claims, demands, or causes of action that you, your estate, heirs, administrators, executors, or assigns may have for any loss, illness, personal injury, death, or property damage arising out of, connected with, or in any manner pertaining to the RELEASEES’ presence in, on, or upon the property whether caused by negligence of the RELEASEES, accident, deliberate act, omissions, or otherwise. You, the foster family, understand and acknowledge the fact that canines can be unpredictable and CCR is not responsible if injury should occur to you, any members of your family, or third parties resulting from the canines fostered or adopted through the CCR program. In signing this agreement, you, the foster family of the dog, acknowledge and represent that you have read and understand this agreement; that you sign this agreement voluntarily; no oral representations, statements, or inducements have been made; you are at least eighteen years of age and fully competent; you understand that you are giving up substantial rights by signing this agreement; and you voluntarily agree to be bound by this agreement.

I am I full agreement with the CCR foster program and foster care responsibilities. By signing below I am attesting to the truthfulness of my answers.
Signature:
Date: