It Takes A Village Non-profit Rescue

Date

/ Month / Day Year

Full Name

First Name Last Name

Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Phone Number

- Area Code Phone Number

Name(s) of other Adults in the Household

E-mail

Place of Employment

What type of dog are you interested in fostering?

Do you have any restrictions on the type of dog you will foster?

Who will be the primary caretaker of the dog?

Do you live in a

Do you

Own Rent Live with Parents\Guardian

If renting, does your landlorf/rental agency allow pets?

Yes No

Landlords Name

First Name Last Name

Landlords Phone Number

- Area Code Phone Number

How long have you lived at your present address?

Do you anticipate moving within the next 6 months?

Yes No

Do you have children at home?

Yes No

Ages?

Are they use to Animals?

Yes No

Is anyone allergic to animals?

Yes No

Do all adult members of the household know that you plan to foster a dog?

Yes No

Is everyone in the household aware of the time and attention a dog needs?

Yes No

What is the typical family schedule like?

Please explain why you want to foster a dog?

Do you have other animals at home?

Yes No

How many?

Breed, age, sex, spay/neutered, time owned, licensed, personality with other dogs

Are all your pets current on their vaccinations?

Yes No

What is the name and address of your veterinarian/clinic?

How many hours per day will this pet be alone? (without human companionship)

Where will this dog be during the day?

Where will this dog be during the night?

Will this dog be allowed indoors?

Yes No

Where will this dog sleep?

When the animal is outside, will it be:

Ina fenced yard On a leash Allowed to run loose On a trolley Chained Other

Please explain if other:

If the yard is fenced, will it safely confine this animal?

Yes No

Type of fence?

Are you aware of your local animal control regulations?

Yes No

Do you know basic dog obedience techniques?

Yes No

Do you know how to crate train a dog?

Yes No

Please describe any training/experience you have had in handling animals:

What if your pet plays roughly/is aggressive with the foster?

What will you do if your foster has a potty accident in the house?

What do you plan to do if the foster dog does not work out in your home for any reason?

I certify that the above information is accurate, and that I have willingly provided it to It Takes a Village Canine Rescue, Inc. I will notify It Takes a Village Canine Rescue, Inc. of any changes related to this information. By signing below, I certify that the information I have given is true and that any misrepresentation of facts may result in my losing the privilege of fostering a companion animal from It Takes a Village Canine Rescue, Inc.

Foster's Signature

Date

/ Month / Day Year

FOSTER'S AGREEMENT AND RELEASE

**Please read carefully and initial each statement!**

I agree that the animal will not be allowed outdoors without proper supervision. When taking the animal outdoors, he/she will be on a secure harness and wear proper identification

My current pets are up to date on any necessary vaccinations and in good health as advised by my vet.

I agree to care for the animal in a humane manner and be a responsible animal guardian. This includes supplying adequate food, water, shelter, attention, a safe environment and advising It Takes a Village Canine Rescue, Inc. (ITV Rescue) representatives if the dog needs medical care.

I will check my foster dog regularly for any signs of illness. I will do frequent flea and tick checks on my foster dog

I understand that I will not incur any expenses related to the dog, including veterinary care with the prior express consent of ITV Rescue. If I incur expenses related to the dog without prior consent from ITV Rescue, I understand that I am personally responsible for those expenses.

I will never leave my foster dog unattended in a vehicle when it is 75 degrees or hotter, even with the windows rolled down. I understand that this can cause heat stroke and the death of a dog.

I agree to arrange my family’s schedule so that the dog is seldom left alone for more than eight hours at a stretch. I agree to play with, pet and give attention to my foster dog when I am home.

I will not hit my foster dog as punishment. I understand that dog trainers acknowledge that this is an ineffective way of changing bad behavior. I will seek to modify behavior by praising the behavior that I desire. I agree to consult with the rescue, the Pet Helpline (480) 898-7387, dog care books or videos from the library if I am experiencing any behavior difficulties with my foster dog.

I will closely supervise my dog when around children (especially children, or adults, he/she is not familiar with). I will closely monitor my foster dog when near roadways or water, when riding in a vehicle, and in any other situation which is potentially dangerous to my foster dog. I will have my foster dog wear an identification tag (preferably with a phone number) at all times. If I do not have identification, I will ask to find out where an identification tag can be obtained. If my foster dog happens to escape his/her confinements while in my care, I agree to inform ITV Rescue immediately and try to locate the foster dog

I agree that if at any point I decide that I cannot keep the animal for any reason, I will return him/her to It Takes A Village Rescue, Inc. without requesting a fee.

I understand that It Takes a Village Canine Rescue, Inc. has little or no knowledge of the animal, including its medical condition/background and disposition of the animal. It Takes a Village Canine Rescue, Inc. makes no warranties with regard to the health or temperament of the animal and disclaims any liability for the animal’s medical condition, temperament, sickness or disease

I give It Takes A Village Rescue, Inc. permission to call or visit my home at any reasonable time to assure that the animal is being properly treated and cared for.

The animal will not be subject to harassment by myself or other persons who live or visit my home, and will be protected from other animals in my care

I will relinquish the dog upon request. I also understand that, if for any reason, I am unable to continue fostering a particular dog, I will give ITV Rescue adequate time to find the dog another foster.

I release and forever discharge It Takes a Village Canine Rescue, Inc., its board, volunteers, foster homes and representatives, and the veterinarian treating the animal at the request of It Takes a Village Canine Rescue, Inc., from any and all claims and actions, including, but not limited to property damage caused by the animal, personal injury to me, family members, third parties or other animals from biting, scratching, transmittal of disease, and/or any other matter attributable to said animal. Any animal has the potential to bite or cause injury. I further agree to indemnify and hold harmless It Takes a Village Canine Rescue, and its board, volunteers, foster homes and representatives, joint and severally, from any and all actions, claims, and demands for, upon or by reason of any damage, loss or injury, which hereafter may be sustained by adoption of the animal.

I acknowledge that It Takes a Village Canine Rescue, Inc. is an Indiana non-profit organization and any disputes or disagreements arising from my dealings with ITV Rescue are subjected to Indiana law and I consent to the exclusive jurisdiction of Indiana law. If ITV Rescue is forced to retain an attorney in enforcing this contract, recipient agrees to pay ITV Rescue’s reasonable attorney’s fees and costs incurred in same.

I UNDERSTAND AND AGREE TO THE ABOVE TERMS. IF, AT ANY TIME, I AM UNABLE TO CARE FORTHE ANIMAL ACCORDING TO THE CONDITIONS STATED ABOVE, I WILL ALLOW IT TAKES A VILLAGE CANINE, INC. TO RESUME CONTROL OF THE ANIMAL OR FIND AN ALTERNATIVE SOLUTION. I UNDERSTAND THAT IF I KNOWINGLY FAIL TO COMPLY WITH THE ABOVE TERMS, OR IN ANY WAY PUT THEANIMAL IN A SITUATION WHICH ENDANGERS IT ’S HEALTH, IT TAKES A VILLAGE CANINE, INC. MAY TAKE APPROPRIATE ACTION, INCLUDING LEGAL ACTION, TO TAKE THE PET FROM MY POSSESSION.

Foster's Signature

Date

/ Month / Day Year

If you have any questions, please call (812) 250-9247 or email us at itvrescue@gmail.com

It Takes a Village Canine Rescue, Inc. reserves the right to refuse any applicant!

It Takes A Village Non-profit Rescue

Foster Application