Evergreen Golden Retriever Rescue

EGRR Adoption Application

First Name Last Name

Street City State Zip Code

** One of three phone numbers is required

Phone Day Phone Evening Phone Cell Best time to call

Email Best way to contact you

Occupation

List other adults who live in your home:

List children and their ages:

Please describe the activity level of your household:

Do you have frequent visitors, human or canine? If so, describe:

Do you have any dogs of your own? If so, please list them by breed, gender (note if neutered) and age:

Do you have cats or any other pets? If so, please list:

How do your dogs react to new dogs?

Are your pets up to date on their vaccinations?

Do you or neighbor's have livestock that a foster dog could come into contact with? If so, please describe:

Is your yard fenced? If so, what type and height:

Approx size:

Is it totally enclosed and secure? If not, explain:

Is your yard chemically treated? If so, with what:

How often?

Do you have an enclosed kennel run? If so, specify size and type:

Do you have crates? If so, specify size and type:

What is the longest time you would expect to leave the foster dog unattended?

How often?

Where would the dog stay when you are gone?

When you are home?

Where would the dog sleep at night?

What type of experience have you had with Goldens or other dogs?

Have you fostered dogs before?

Do you have any special skills (groomer, trainer, vet or vet tech)?

How much and what type of training experience do you have?

How long would you be able to foster each dog for?

Do you have a preference as to the age, sex or energy level of the dogs you foster?

Could you foster a dog with Kennel Cough? Dog with behavior issues? A puppy? A dog that is not housebroken? Injured dog?

Are you available for transport (from shelter or to a vet)?

List distance and time restrictions?

Are you comfortable answering potential adopter's questions about the dog over the phone and arranging for them to meet the dog at your house?

Any restrictions?

References: Please provide the names and phone numbers of 2 references who know dogs and are knowledgeable about the care and training you give your dogs that we may contact:

Name: Phone: Credentials:

Name: Phone: Credentials:

Foster Care Provider Agreement:

I / We have read and agree to abide by the following conditions when a foster dog is in my/our care:

1. I / We understand that our role is that of a temporary home for each foster dog. While in my home, foster dogs remain the property of Evergreen Golden Retriever Rescue and must be immediately surrendered upon request by an authorized EGRR agent. Should legal action be taken to recover a foster dog, I / we will pay all court costs and legal fees.

2. Should I / We choose to adopt one of my / our foster dogs, I / we will notify the Placement Coordinator before placement calls are made on the dog and I / we will pay the customary requested adoption donation.

3. I / We will provide adequate food, water clean living conditions and exercise for each foster dog.

4. At no time will the foster dog be allowed to run free. A foster dog will be allowed off leash only when in a fenced or secure area and under direct supervision.

5. At no time will a foster dog be tied or chained outside or transported in the open bed of a pick-up truck or similar vehicle.

6. I / We understand that it is my / our responsibility to keep the dog safe and secure in a crate or other confined area when the dog is alone so as to protect both the dog and my / our home and belongings.

7. I / We understand that it is my / our responsibility as a foster home to assess the foster dog's temperament and to prepare him / her for adoption and to do this, the dog must spend time inside the home with me / us.

8. Only pre-approved veterinary expenses will be reimbursed and receipts must accompany the request for reimbursement.

9. EGRR may reimburse for other expenses but they must be pre-approved and receipts must accompany the request for reimbursement. Expenses not pre-apporoved may not be reimbursed.

10. Foster dogs must never be given to another home without the approval of the Foster Home Coordinator or other designated representative.

11. Should a foster dog be lost or stolen, I / we will immediately notify the Foster Home Coordinator or designated EGRR representative.

12. I / We understand that it is not my/our responsibility to find a home for my / our foster dog - that EGRR has a waiting list of people wanting to adopt and it is the job of the Placement Coordinator to do this.

13. All adoption donations will be immediately forwarded to the Treasurer. Vet records along with the adoption packet will be given to the adopting family.

14. I / We will immediately notify the appropriate EGRR representative of any problems. Should I / we fear for my/our safety or that of my / our family, I / we will take the dog to the nearest vet for boarding until disposition can be determined.

15. I / We understand that despite EGRR's best efforts to provide as much information as possible, EGRR cannot guarantee the health, behavior or temperament of foster dogs, so great care should be taken with each dog especially when they are new in my / our home and under stress.

16. I / We agree that it is my/our decision to foster Golden Retrievers for EGRR and will not hold EGRR liable for any damage, injury or harm to myself / ourselves, my / our family or property caused directly or indirectly through my / our fostering activities. I / We carry insurance coverage in the event of personal or liability damages resulting from fostering dogs for EGRR. I / We accept responsibility for any and all events that occur in connection with the fostering of a dog for EGRR.

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