First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

County*

Email*

Home Phone*

Work Phone
x

Cell Phone*

Alt Email

Text/Pager Email

List the name and ages of all members of your household*

Have your children lived with pets in the past?*

Do all members of your household agree to bringing in another pet?*
Choose one: No Yes

What type of animal(s) are you willing to foster?

Please list all animals currently in your home. Include whether they are spayed or neutered, up to date on vaccinations, gender, age, type of animal and breed?*

What type (dog or cat) size, age, activity level are you willing to foster?*

Is there a time limit to how long you are willing to foster a pet or are you willing to foster until the pet is adopted?*

Please list the name, phone number and email addresses of 3 personal references.*

Are you willing to have an ODAAT representative come to see where the dog will be living?*
Choose one: No Yes

Please list your current veterinarian including their phone number and name on account. Also, please call you vet to let them know we will be contacting them for a veterinary reference. *

Is it OK for us to contact your current veterinarian?*
Choose one: No Yes

Do you own or rent?*

If you rent, we must be able to contact the landlord to obtain permission for this dog to live in your home. Property's owner name & phone number:

What kind of housing do you live in?*
Choose one: Apartment Townhouse Duplex Ranch Two Story Mobile Home

Do you have a fenced in yard?*
Choose one: No Yes

What type of fence do you have?

If no fence is installed, how will you keep the dog on your property?

Does your home have a doggie door?*
Choose one: No Yes

Do any members of your household have allergies to dogs/cats?*

How many hours a day will your pet be without human companionship? Please explain:*

What methods will you use to exercise the dog?*

If the dog/puppy is not housebroken, what methods will you use to train it?*

Do you live near a busy road?*

1. Any animal(s) fostered by me will be kept in a ODAAT approved facility/residence. I understand that any animal(s) I foster is/are the property of ODAAT, and I agree to turn it/them over to ODAAT immediately upon request. I agree to bring any animal(s) fostered by me to the veterinarians approved and coordinated thru ODAAT for exams, vaccinations, weight checks, or any other reason deemed necessary by ODAAT at a mutually agreed upon date and/or time. 2. I understand that I am responsible for adhering to all ODAAT standards of care and applicable.*
Choose one: No Yes

I (print name) born on (Date) fully understand and agree to assume any and all risks involved in any and all duties that I perform for One Dog At A Time, also known as ODAAT in my capacity as a volunteer for this organization. Here in after jointly known as RESCUE. I understand and agree to hold RESCUE harmless for any injury or injuries which I may sustain during the course of my volunteer duties for RESCUE including, but not limited to: the risks of being bitten, scratched, injured, or frightened by cats, kittens, dogs, and puppies or any animal under my care as a volunteer for RESCUE. I understand and agree that RESCUE is not liable for any injuries, damages, liabilities, losses, judgments, costs, or expenses whatsoever that I may suffer or sustain in connection with the performance of my volunteer activities unless they are the result of RESCUE gross negligence (defined as: a carelessness and reckless disregard for the safety or lives of others, which is so great it appears to be almost a conscious violation of other people's rights to safety) or intentional misconduct. I will indemnify, defend, and hold RESCUE harmless from and against any claims, lawsuits, injuries, damages, losses, costs, or expense whatsoever sustained by any companion animal or any person in connection with my intentional misconduct or grossly negligent performance of volunteer activities for the RESCUE or with my breach of RESCUE’s rules, regulations, policies, and programs. If I will be sheltering or providing foster care or boarding for any RESCUE animals in my home or business, I consent to RESCUE visiting my home or business from time to time to observe the animals and their living quarters. I also agree that these visits may be unplanned or unscheduled prior to the actual visit. This Hold Harmless Agreement will forever prevent me from seeking any legal actions whatsoever against the RESCUE organization or any of its representatives. If you agree to the above please enter your Date of Birth, name and that you agree to the terms of the Hold Harmless Form.*