CCHDR Foster Application

All the information below must be supplied in order to be considered for foster. An incomplete application may be delayed or rejected.

Spouse / Partner's Name

Date of Birth (Spouse)

Address (House Number, Street, City, State & Zip Code)

Are you (check one)?

Place of employment (if working) and how long have you worked there?

Do you own your home?

REQUIRED IF RENTING: Landlord Name and Phone Number (you must supply the actual property owner's contact information and fill out the Landlord Permission Form, separately)

Type of Residence?

How long have you lived at this residence?

Are there other adults that live in the home? Provide their name(s), DOBs and relationship to adopter

Are there children in the home?

How old is the child(ren)?

Are any household members allergic to pets? If "Yes," please explain who is allergic and the nature of the allergy:

Amount of time you or another adult is usually home (check one)?

Home all day

Out part-time

Away 7-10 hours daily

Other

If you checked "OTHER" (above), please explain:

Who will be responsible for the dog's training and exercise? What type of training and exercise will you provide? How often?

Dog ownership experience?

None

Have had dogs in the past

Experienced

Dog fostering experience?

None, this will be my first time

Moderate (1 - 5 dogs)

Experienced (6+ dogs)

What type of vehicle and where IN the vehicle will you transport the dog?

Number of hours dog will be left alone daily?

0 - 1

2 - 4

5 - 7

8+ / other

If you checked "8+/OTHER" (above), please explain:

Where will the dog be kept when left alone?

Where will the dog be kept primarily during the day?

If you checked "OTHER" (above), please explain:

Where will the dog be kept at night?

If you checked "OTHER" (above), please explain:

Do you have a fenced yard? If "YES," describe the type of fence and height at lowest point:

When it comes to dogs, I tend to be more (check one)?

Strict / Demanding (dog must learn and follow all commands)

Moderate (encouraging of good behavior)

Lenient (wishy-washy, easily coerced by dog)

The noise / activity level in my home is usually:

High

Medium

Low

Length of time you are able to foster?

One week or less

2 - 4 weeks

1 - 3 months

As long as it takes to find the dog a forever home

I can be available to meet with prospective adopters and/or bring the dog to CCHDR adoption events if asked?

I would prefer a dog that:

Enjoys walking with me on a leash

Exercises him/herself in our yard

Enjoys going to the dog park

Will run, jog, hike with me

Requires only enough exercise to do his/her business

CURRENT PETS: please include name / species / breed / age / sex / spayed or neutered?

Name and city of the veterinarian or vet clinic you use:

Who is designated as responsible for your dog(s) if you are on vacation, have an emergency, or can no longer care for your animals?

DISCLAIMER & APPLICANT SIGNATURE

This Voluntary Release/Waiver of Liability (the Release) is made and entered into between the undersigned and Central Coast Herding Dog Rescue (CCHD Rescue, LLC) effective as of the below-indicated date. The undersigned desires to adopt and/or foster an animal from CCHD Rescue, LLC, and as an inducement to CCHD Rescue, LLC to agree to the adoption and/or foster, the undersigned hereby represents, acknowledges and agrees as Follows: * I acknowledge that, due to the unpredictable nature of animals, certain risks and dangers may occur while caring for an animal, including risks of injury to person and property, and that I have voluntarily agreed to make the adoption and/ or foster contemplated herein with full knowledge of such risks and hereby voluntarily assume all of such risks. * I agree that I will not make any claims against, sue or attach any property of CCHD Rescue, LLC, its directors, officers, agents, employees and/or volunteers, including, without limitation, CCHD Rescue, LLC for any injury or damage caused by any animal(s) adopted or fostered from CCHD Rescue, LLC. Any actions against CCHD Rescue, LLC will take place in San Luis Obispo County, CA. * I hereby voluntarily release, discharge, waive and relinquish any and all actions or causes of action for personal injury, property damage or wrongful death occurring to me or third parties as a result of any action or activity of any animal(s) adopted or fostered by me from CCHD Rescue, LLC, wherever and however the same may occur which I may have against Rescue or any of its directors, officers, agents, employees or volunteers, including, without limitation, Central Coast Herding Dog Rescue, whether the same shall arise by the negligence of said persons or otherwise. IT IS MY INTENTION BY THIS INSTRUMENT TO EXEMPT AND RELIEVE RESCUE FROM ALL LIABILITY FOR PERSONAL INJURY, PROPERTY DAMAGE OR WRONGFUL DEATH CAUSED BY NEGLIGENCE OR OTHERWISE. * I hereby agree to hold CCHD Rescue, LLC and its directors, officers, agents and/or employees, including, without limitation, harmless and indemnity them from and against any liability claims, judgements or expenses I may incur arising out of my adoption or foster of an animal from CCHD Rescue, LLC and/or my ownership or care of any such animal Thereafter. * I agree that in the event I can no longer provide a safe environment for the dog being adopted or fostered, I will consult with Central Coast Herding Dog Rescue and return the dog if requested to do so. The foster further specifically acknowledges: * That fostering activities are being performed on a strictly voluntary basis; * Their fostering activities are not under the direct supervision of Central Coast Herding Dog Recue (CCHD Rescue, LLC), and that any advice or recommendations provided by CCHD Rescue, LLC are not strict guidelines or requirements; * Fostering activities involve working with dogs, and that such work is inherently risky; * Their fostering activities fall under the California "Veterinarian's Rules" applicable to boarding and/or training a dog; * That they assume the risk of personal injuries that might result from fostering a dog; * That, absent gross negligence or recklessness on the part of the CCHD Rescue, LLC, they hold CCHD Rescue, LLC harmless for any personal injuries that might result from fostering a dog; * And that foster is solely responsible for the welfare and behavior of dogs they chose to foster. * I HAVE CAREFULLY READ THE FOREGOING, AND I UNDERSTAND THAT TOGETHER THEY CONSTITUTE A DISCLAIMER OF LIABILITY BY CCHDR AND A RELEASE OF ALL CLAIMS BY ME. I UNDERSTAND THAT I ASSUME ALL RISKS INHERENT IN MY DECISION TO ADOPT OR FOSTER AN ANIMAL FROM CCHDR AND ANY RELATED ACTIVITIES. I VOLUNTARILY SIGN BELOW TO EVIDENCE MY ACCEPTANCE OF THE ABOVE PROVISIONS. * If any portion of this Release is held invalid, it is agreed that the balance thereof shall continue in full legal force and effect. * This Release is governed by laws of the State of California applicable to agreements entered into and fully performed therein.

Your Signature

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CCHDR Foster Application

All the information below must be supplied in order to be considered for foster. An incomplete application may be delayed or rejected.

Spouse / Partner's Name

Date of Birth (Spouse)

Address (House Number, Street, City, State & Zip Code)

Are you (check one)?

Place of employment (if working) and how long have you worked there?

Do you own your home?

REQUIRED IF RENTING: Landlord Name and Phone Number (you must supply the actual property owner's contact information and fill out the Landlord Permission Form, separately)

Type of Residence?

How long have you lived at this residence?

Are there other adults that live in the home? Provide their name(s), DOBs and relationship to adopter

Are there children in the home?

How old is the child(ren)?

Are any household members allergic to pets? If "Yes," please explain who is allergic and the nature of the allergy:

Amount of time you or another adult is usually home (check one)?

Home all day

Out part-time

Away 7-10 hours daily

Other

If you checked "OTHER" (above), please explain:

Who will be responsible for the dog's training and exercise? What type of training and exercise will you provide? How often?

Dog ownership experience?

None

Have had dogs in the past

Experienced

Dog fostering experience?

None, this will be my first time

Moderate (1 - 5 dogs)

Experienced (6+ dogs)

What type of vehicle and where IN the vehicle will you transport the dog?

Number of hours dog will be left alone daily?

0 - 1

2 - 4

5 - 7

8+ / other

If you checked "8+/OTHER" (above), please explain:

Where will the dog be kept when left alone?

Where will the dog be kept primarily during the day?

If you checked "OTHER" (above), please explain:

Where will the dog be kept at night?

If you checked "OTHER" (above), please explain:

Do you have a fenced yard? If "YES," describe the type of fence and height at lowest point:

When it comes to dogs, I tend to be more (check one)?

Strict / Demanding (dog must learn and follow all commands)

Moderate (encouraging of good behavior)

Lenient (wishy-washy, easily coerced by dog)

The noise / activity level in my home is usually:

High

Medium

Low

Length of time you are able to foster?

One week or less

2 - 4 weeks

1 - 3 months

As long as it takes to find the dog a forever home

I can be available to meet with prospective adopters and/or bring the dog to CCHDR adoption events if asked?

I would prefer a dog that:

Enjoys walking with me on a leash

Exercises him/herself in our yard

Enjoys going to the dog park

Will run, jog, hike with me

Requires only enough exercise to do his/her business

CURRENT PETS: please include name / species / breed / age / sex / spayed or neutered?

Name and city of the veterinarian or vet clinic you use:

Who is designated as responsible for your dog(s) if you are on vacation, have an emergency, or can no longer care for your animals?

DISCLAIMER & APPLICANT SIGNATURE

Your Signature

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