Dog Short-Term Foster Signup Form

Name*

First Name * Last Name *

Email*

Home Address*

Street Address * City * State * ZIP Code *

Mobile Phone Number*

Are you over 18 years old?*

Yes
No

Do you currently have children?*

Yes
No

Do you own or rent your home?*

Own
Rent

Does your landlord allow dogs?*

Yes
No

On average, how many hours per day are you away from home on WEEKDAYS?*

On average, how many hours per day are you away from home on WEEKENDS?*

Do you currently have pets?*

Yes
No

Please list pets currently living in your household*

Name	Type (i.e., Cat, Dog)	Age	Gender	Spayed/Neutered (enter Y or N)	Indoor or Outdoor

Are your pets current on their vaccinations and receiving monthly heartworm preventative?*

Please check all that apply

Yes - rabies within 1 year
Yes - DHPP within 1 year
Yes - bordatella within 6 months
Yes - heartworm preventative monthly
No

Name of veterinarian/vet clinic you use for your personal pets*

Phone number of veterinarian/vet clinic*

Please review and provide consent for the following agreements.

Vaccinations and Preventatives*

I understand the importance of regular vaccinations, heartworm preventatives and veterinary care. I agree to give preventatives as provided. I will take the dog in my care for vaccination and other veterinary appointments as directed by DFWHS.

I agree

Veterinary Care*

I understand that the long-term health of the foster dog in my care cannot be guaranteed. Typically, a medical evaluation of the animal will be done before placing a dog into my care, however other issues might present once in my care (examples: tapeworms, upper respiratory infection, ear infection, etc). I will alert the foster coordinators to any observed issues and follow instructions for getting veterinary care for the foster dog in my care.
I understand that if I choose to take my foster pet to a personal vet/emergency care without approval from DFWHS staff, I will not be reimbursed for the cost of care.

I agree

Hold Harmless*

Fostering a pet is not without risk. I understand that DFWHS is not responsible for: damage to my personal property caused by fostered pets; illness or injury to my own animals caused by fostered pets; personal injury caused by fostered pets.

I agree

Puppies Under 4 Months*

For Puppies under 4 months only: I understand that my pet may not yet be spayed/neutered. DFWHS will authorize an appointment for me to get my foster pet spayed or neutered.

I agree

Entire Agreement*

This Agreement and all addendum shall supersede all prior discussions, promises, representations or understandings, oral and written, among the parties in connection with the subject matter hereof.

I agree

I, for myself, my heirs, executors, administrators, and assigns, hereby release, indemnify and hold harmless DFW Humane Society, its volunteers, board members, and directors, and their heirs, administrators, executors, successors and representatives from all liability for and all risk of damage or bodily injury or death that may occur to me and my property (including any injury based on negligence) now or hereafter in connection with my foster animal(s) and my participation in the DFW Humane Society Foster Program. I expressly agree that this release, waiver, and indemnity is intended to be as broad and inclusive as permitted by the state of Texas and that if any portion is invalid, the remainder shall continue in full force and effect. By my (digital) signature below and by selecting "I agree" on the statements above, I affirm that all statements and stated agreements contained in this document are truthful. I affirm that I have read and understood this Agreement in its entirety, and I agree to abide by the terms of this Agreement. shall not hold DFW Humane Society liable, or responsible for, and DFW Humane Society shall be saved and held harmless from and against any and all claims and damages of every kind, for injury to any person or persons, and for damage to or loss of property arising out of or attributed to, directly or indirectly, the operations or performance of the above named potential adopter under this agreement, including claims and damages arising in whole or in part from the negligence of DFW Humane Society. Please type your initials below to indicate your understanding and agreement

Please type your initials*

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Signature*

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Dog Short-Term Foster Signup

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