Name* First Last Cell PhoneHome PhoneWork PhoneAddress* Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* What kind of animal(s) are you interested in fostering?*Name(s) and ages of other adult member(s) of householdWho will be responsible for this animal?*What kind of home do you live in?*HouseApartmentMobile HomeDuplexDo you:*OwnRentLive with parents/relative/friendIf renting, does your landlord/rental agency allow pets?YesNoI don't knowLandlord's name First Last Landlord's phoneHow long have you lived at your present address?*If you have children at home, what are their names and ages?Are they used to animals?YesNoIs anyone living in your household allergic to animals?*YesNoDo all adult members of the household know that you plan to foster a pet?*YesNoDescribe your household activity level/noise level.*What is the typical family schedule like?*Please explain why you want to foster a pet?*Do you have other pets at home?*YesNoAre the other dogs and cats in the home spayed or neutered?YesNoIf no whyPlease list for all pets that will come into contact with this foster pet: Breed, age, sex, spay/neutered, time owned, personality with other dogs:Are all your pets current on their vaccinations?YesNoI don't knowWhat 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 animal be during the day?*Where will this animal sleep?*When this animal is outside, will it be in a fenced yard, on a leash, allowed to run loose, on a trolley, Chained? (Please indicate all that apply.)*Do you have a fenced yard?*YesNoIf you have a fenced yard, how high is it (how many feet tall) and what is it made of (chain link, stockade, etc.)?Are you aware of your local animal control regulations?*YesNoDo you know basic dog obedience techniques?*YesNoDo you know how to crate train a dog?*YesNoFOSTER'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.*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 Safe Haven Animal Rescue representatives if the pet needs medical care.*I will check my foster pet regularly for any signs of illness. I will do frequent flea and tick checks on my foster pet.*I understand that I will not incur any expenses related to the pet, including veterinary care with the prior express consent of Safe Haven Animal Rescue. If I incur expenses related to the pet without prior consent from Safe Haven Animal Rescue, I understand that I am personally responsible for those expenses.*I will never leave my foster animal 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 pet.*I agree to arrange my family’s schedule so that the pet is seldom left alone for more than eight hours at a time. I agree to play with, pet and give attention to my foster pet when I am home.*I will not hit my foster pet as punishment. I understand that pet 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 will closely supervise this pet when around children (especially children, or adults, he/she is not familiar with). I will closely monitor my foster animal when near roadways or water, when riding in a vehicle, and in any other situation which is potentially dangerous to my foster animal. I will have my foster animal 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 animal happens to escape his/her confinements while in my care, I agree to inform Safe Haven Animal Rescue immediately and try to locate the foster pet.*I agree that if at any point I decide that I cannot keep the animal for any reason at any point during the foster period, I will return him/her to Safe Haven Animal Rescue and allow reasonable time (24 hours) for pick up or will return myself to requested location by the agency.*I understand that Safe Haven Animal Rescue has little or no knowledge of the animal, including its medical condition/background and disposition of the animal. Safe Haven Animal Rescue 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 Safe Haven Animal Rescue 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 animal upon request. I also understand that, if for any reason, I am unable to continue fostering a particular pet, I will give Safe Haven Animal Rescue adequate time to find the pet another foster.*I release and forever discharge Safe Haven Animal Rescue, its board, volunteers, foster homes and representatives, and the veterinarian treating the animal at the request of Safe Haven Animal Rescue 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 Safe Haven Animal 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 fostering an animal.*I acknowledge that Safe Haven Animal Rescue is an Oklahoma non-profit organization and any disputes or disagreements arising from my dealings with Safe Haven Animal Rescue are subjected to Oklahoma law and I consent to the exclusive jurisdiction of Oklahoma law. If Safe Haven Animal Rescue is forced to retain an attorney in enforcing this contract, recipient agrees to pay Safe Haven Animal 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 FOR THE ANIMAL ACCORDING TO THE CONDITIONS STATED ABOVE, I WILL ALLOW SAFE H AVEN ANIMAL RESCUE 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 THE ANIMAL IN A SITUATION WHICH ENDANGERS ITS HEALTH, SAFE HAVEN ANIMAL RESCUE MAY TAKE APPROPRIATE ACTION, INCLUDING LEGAL ACTION, TO TAKE THE PET FROM MY POSSESSION.*I CERTIFY THAT THE ABOVE INFORMATION IS ACCURATE, AND THAT I HAVE WILLINGLY PROVIDED IT TO SAFE HAVEN ANIMAL RESCUE. I WILL NOTIFY SAFE HAVEN ANIMAL RESCUE 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 SAFE HAVEN ANIMAL RESCUE.*Would you like to sign up for our email newsletter? We'll never share, sell or use your email address for anything other than occassional emails about Safe Haven activities. You can unsubscribe at any time.*Yes, sign me up!No thanks.Your Signature*Type your nameToday's Date* Please note that we will respond to this application within 48-72 hours Mon-Fri. After you hit the "submit" button, you should receive confirmation of your submission. If you do not receive confirmation or a response from us, we likely did not receive your application. Please email us at firstname.lastname@example.org if you do not receive a response from us. If you have questions, please call (405) 463-1556. Safe Haven Animal Rescue reserves the right to refuse any applicant! Thank you!