Short Mugs Rescue Squad

First Name*

Last Name*

Address*

City*

State/Province*

Zip/Postal Code*
 - 

Email*

Home Phone

Work Phone
x

Cell Phone*

What is the nearest major city?

Age of applicant*

What is your occupation?*

Spouse/Significant Other name, age, occupation.*

What is your spouses phone number?*

How many children in your home name, ages?*

Please list any person that lives with you in addition to your spouse or children, their age and relation.*

Have you ever owned a french bulldog?
Choose one: Yes No

Do you have experience with brachycephalic dogs (smush faced dogs)? Please explain.*

If you currently own a dog/dogs please list their name, age, sex, breed and if spayed/neutered.*

Please list all other pets in the home, thier name, age, breed and if they are spayed/neutered.*

Have you had to rehome any pets? Why?*

Have any of your current or past pets been outdoor only?*

How much time will the animal spend alone during the day?*

Why do you want to start fostering with SMRS?*

What behaviors are you not willing to foster?

Please list other skills you may have that would assist SMRS.*

List at least one reference (who is not a family member) name, relationship and phone number.*

Please list a reference from the rescue community if you have one. If not, please list another non-family member name, relationship and phone number.*

Veterinarian's Name and clinic name and phone number.*

What brand of heartworm and flea prevention do you use?*

Is your dog current on vaccines? If so, please list which shots ie (rabies, dhpp, bordatella) and date last given.*

Do you agree to allow a SMRS representative visit your home prior to adoption?*
Choose one: Yes No

Have you applied with any other rescues? If yes, which ones? Please list name of rescue.*

In what type of home do you live*
Choose one: Single Family Duplex Apartment Townhouse Condominium Mobile Home Military Housing

Do you own or rent your home*
Choose one: Rent Own

Do you have a pool or body of water (pond) on your property?*
Choose one: Yes No

Is your pool or body of water fenced? If yes, please describe.*

Do you have stairs in your home? If yes, please describe.*

If you rent, have you received the approval of your landlord to have an animal
Choose one: Yes No

If you rent, please enter your landlord's name and phone number

Is your yard fenced?*
Choose one: No Yard Unfenced Yard Yard Partially Fenced Yard Completely Fenced

What type of fence?*
Choose one: Privacy Wrought Iron Chain Link Invisible None

What is the height of the fence*

Which best describes the area you live in?*
Choose one: City Rural Suburban Urban

I understand that brachycephalic dogs can only be kept indoors.

I understand that my foster must be kept seperate from my other pets when I am not home.

I understand that the foster dog should not be taken to any public outings, ie. Dog Parks, Festivals, Mobile Adoptions, Dog Shows, without prior approval from a Board Member:

I understand that I will be responsible for transporting the foster dog to an approved veterinarian for appointments. Vet care should be provided by one of Short Mugs' approved veterianarians.

I understand that if an emergency arises, I will be financially responsible for the foster dog's veterinarian bills if I am unable to get in touch with a Board member. Veterinary care costs will be reimbursed by SMRS, but only with written or verbal approval of procedures and invoice proof.

I understand that for reimbursement of any and all veterinary services for the foster dog, a Board Member must approve the services prior to the appointment.

I agree that if my foster dog does not work in my home, I will notify Short Mugs immediately and give them sufficient time to find a new foster home.

I agree that the foster dog is the sole property of SMRS and cannot be given or adopted to anyone without SMRS'prior written permission. I agree that SMRS or a representative can take back the foster dog at any time for no reason. If I should find someone who is interested in adopting the foster dog, I agree that the adoptive home must complete all SMRS paperwork and be interviewed by a SMRS representative.

Please understand that it is Short Mugs' priority to serve the best interest of the dogs in our care. Therefore, SMRS reserves the right and sole discretion to refuse fostering to anyone for any reason. I understand that the term foster means a person who freely chooses and renders services to Short Mugs Rescue Squad in a voluntary capacity. I agree to hold Short Mugs harmless of any injury(s), damage(s), and/or disease(s) which I might sustain from handling the rescues during the course of my foster duties. I fully understand and agree to assume all risks involved in any and all duties that I perform for Short Mugs. As a foster, I agree to provide love, food, indoor housing and transport for my rescue. I also agree that while the rescue is in my custody, the rescue remains a part of Short Mugs' Rescue program. I fully understand and agree that either for failure to fully comply with any and all of the obligations outlined in this Foster Home Contract, or for any reason whatsoever, while performing any foster services in a voluntary capacity, Short Mugs Rescue Squad, at its sole discretion, may immediately terminate my foster services:

I agree to release, discharge, indemnify and hold Short Mugs Rescue Squad harmless for any and all damage(s) to my personal property while performing as a foster in a volunteer capacity any and all duties. I recognize that in handling dogs in a volunteer capacity there exists a risk of injury or sickness, including personal injury or harm. On behalf of myself, my heirs, person representative, and executors, I hereby relese, dicharge, indemnify and hold harmless Short Mugs Rescue Squad from any and all claims, causes of action or demands, or any nature or cause connected with my Foster Home Contract. This might include connection with my foster services based on damages, which may be incurred or sustained by me in any way. Such damages or injuries might include, but are not limited to dog bites, accidents, injuries, and personal property damage. I acknowledge that I have read and understand the terms and conditions of the foregoing Foster Contract and Release and that I will comply with the same. Please type your signature below: *

By typing my full name here, I hereby agree the terms and not to hold Short Mugs or any of its volunteers liable for any physical, emotional or property damages that are a direct or indirect result of activities involved with a Short Mugs rescue dog. Please type name (signature).*

Please type in the date of signature.*