Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone *

(###)

###

####

Do you rent or own? *

Rent

Own

If you rent, are animals allowed? *

Yes

No

N/A

Do you have a yard? *

Yes

No

Is the yard completely fenced? *

Yes

No

N/A

Which describes your normal day? *

home all day

out part-time

gone 7-10 hrs daily

dogs are allowed in my office

Are your pets current on their vaccinations? *

Yes

No

N/A

Are all your pets spayed and/or neutered?

Yes

No

N/A

Will the foster dog be kept loose indoors (check all that will apply). *

Day

Night

Neither

Will the foster dog be kept in the basement (check all that will apply). *

Day

Night

Neither

Will the foster dog be kept the garage (check all that will apply). *

Day

Night

Neither

Will the foster dog be kept in a closed room (check all that will apply). *

Day

Night

Neither

Will the foster dog be kept in the fenced yard (check all that will apply). *

Day

Night

Neither

Will the foster dog be kept in a pen (check all that will apply). *

Day

Night

Neither

Will the foster dog be kept tied outside (check all that will apply). *

Day

Night

Neither

Will the foster dog be kept in a crate (check all that will apply). *

Day

Night

Neither

Have you ever given medication to sick animals before? *

Yes

No

Have you fostered an animal before? *

Yes

No

Has anyone living with you (including roommates) ever been convicted of animal cruelty? *

Yes

No

*

I make the above statements and voluntarily enter into this agreement to provide a temporary home as a foster caregiver to any dogs One Dog at a Time may temporarily place in my care.

*

I agree to provide a One Dog at a Time representative access to all parts of my home and property for a home inspection before my application to foster is approved.

*

I understand that I may be required to provide foster care to my foster animal for an extended and indefinite period of time.

*

I agree that I am over 21 years of age

*

I understand that One Dog at a Time provides no guarantee as to the health of my foster animal and that my foster animal may have medical needs, socialization problems, and may not be housebroken.

*

I agree to provide my foster animal with veterinary care as authorized by One Dog at a Time. I will not arrange or pay for any elective veterinary care for my foster animal without the express consent of an authorized One Dog at a Time representative.

*

I agree to adhere to all relevant zoning and animal control codes and ordinances, whether local, county, or state.

*

I understand that PACFA is allowed to inspect my home, without notice, at any time.

*

I will take all necessary precautions to prevent my foster animal from either impregnating another animal or becoming impregnated. In the event that happens, I will notify One Dog at a Time immediately.

*

I understand that I may only have my foster animal temporarily

*

I agree that I am fostering this animal for One Dog at a Time, and that I do not have any right of ownership over my foster animal. I also agree to provide a One Dog at a Time representative access to my home and property to check on my foster animal at any time that I am in possession of my foster animal.

*

I agree to immediately return any foster animal in my care to One Dog at a Time at the request of its authorized representative at any time and for any reason. If One Dog at a Time is forced to undertake legal action to enforce this provision of the agreement, I agree to indemnify One Dog at a Time for all court costs and attorneys’ fees connected with such an action.

*

If I am planning to move at any time during the period when I am housing a foster animal, I agree to contact One Dog at a Time prior to my move and provide One Dog at a Time with my new contact information. I understand that One Dog at a Time has the right to request return of my foster animal based on my change of residence and agree that I will surrender my foster animal to One Dog at a Time immediately upon request.

*

I understand that as long as I provide foster care to my foster animal to One Dog at a Time’s satisfaction, I will be given the first right of adoption of my foster animal, at such time as One Dog at a Time decides to place my foster animal for adoption.

*

If at any point I can no longer, or do not want, to continue to provide care and shelter for my foster animal, I agree to contact One Dog at a Time and arrange for surrender and return of my foster animal back to One Dog at a Time.

*

I will not transfer possession or custody of my foster animal to any other person at any time, except for temporary, short-term possession for the purpose of vet care, grooming, etc

*

I agree to contact One Dog at a Time with any and all questions or concerns about my foster animal, as well as with any updated contact information.

*

I agree that if I refuse or fail to comply with any provision of this agreement, One Dog at a Time has the right to terminate this agreement and also has the right to the immediate surrender and return of my foster animal. I further consent to provide One Dog at a Time access to my premises if necessary to facilitate the return.

*

I agree that the opportunity given to me to help rehabilitate my foster animal, as well as the chance of a potential future adoption, is of significant benefit to me, and serves as proper legal consideration in exchange for my agreement to the terms of this contract.

*

I have read this One Dog at a Time: Foster Agreement in its entirety, and I agree that all statements and agreements contained in this document are made by me and are truthful, under penalty of perjury under the laws of the State of Colorado.