Are you over the age of 18
Street Address Line 2
State / Province
Postal / Zip Code
Antigua and Barbuda
Bosnia and Herzegovina
Central African Republic
Cocos (Keeling) Islands
Democratic Republic of the Congo
Turkish Republic of Northern Cyprus
Papua New Guinea
Republic of the Congo
Saint Kitts and Nevis
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Sao Tome and Principe
Trinidad and Tobago
Tristan da Cunha
Turks and Caicos Islands
United Arab Emirates
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Home Phone Number
Cell Phone Number
Work Phone Number
Do You Own or Rent
If you rent, are animals allowed
If there are restrictions on animals please explain
If you rent or reside in another person's home, please provide their name and phone numbers
Number of adults in the house
Number of children in the house
Ages of children
Do you have a yard?
Is the yard completely fenced?
Type of fence
Please select all the ones that describe your normal day
Home all day
Gone 7 - 10 Hrs daily
Please indicate the number of pets currently living with you
Name of you veterinarian
Are your pets?
Indoor with just going out to use the restroom and play
Are your pets current on their vaccinations?
Are your dogs spayed and neutered
What type of dogs would you like to foster?
Young un-weaned puppies without a mom
Young un-weaned puppies with a mom
Pregnant dogs through whelping
Sick or injured dogs
How long are you willing to foster at any one time?
Are you willing to foster more than one dog at a time?
Where the animal be kept during the day?
Close in a room
Where the animal be kept during the night?
Close in a room
Have you cared for young, un-weaned puppies before?
Have you ever given medication to a sick animal before?
If yes please explain
Are you willing to provide food and basic needs (excluding vetting and medications) at your own cost?
Have you ever fostered an animal before
If yes, which organization did you foster for?
I agree to provide a Cypress Lucky Mutt Rescue 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 Cypress Lucky Mutt Rescue 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 Cypress Lucky Mutt Rescue, I will not arrange or pay for any elective veterinary care for my foster animal without the express consent of an authorized Cypress Lucky Mutt representative. 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 Cypress Lucky Mutt Rescue immediately. I understand that I may only have my foster animal temporarily. I agree that I am fostering this animal for Cypress Lucky Mutt Rescue, and that I do not have any right of ownership over my foster animal. I further agree that Cypress Lucky Mutt Rescue’s rights in and to my foster animal are superior to mine. I also agree to provide a Cypress Lucky Mutt Rescue 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 Cypress Lucky Mutt Rescue at the request of its authorized representative at any time and for any reason. If Cypress Lucky Mutt Rescue is forced to undertake legal action to enforce this provision of the agreement, I agree to indemnify Cypress Lucky Mutt Rescue for all court costs and attorney 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 Cypress Lucky Mutt Rescue prior to my move and provide Cypress Lucky Mutt Rescue with my new contact information. I understand that Cypress Lucky Mutt Rescue 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 Cypress Lucky Mutt Rescue immediately upon request. I understand that as long as I provide foster care to my foster animal to Cypress Lucky Mutt Rescue’s satisfaction, I will be given the first right of adoption of my foster animal, at such time as Cypress Lucky Mutt Rescue 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 Cypress Lucky Mutt Rescue and understand that moving your foster animal may take time and agree to continue to care for your rescue until such arrangements can be made. 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 my Cypress Lucky Mutt Rescue case manager with any and all questions or concerns about my foster animal or the Foster Care Program as well as with updated contact information. I agree that if I refuse or fail to comply with any provision of this agreement, Cypress Lucky Mutt Rescue has the right to terminate this agreement and also has the right to the immediate surrender and return of my foster animal(s). I further consent to provide Cypress Lucky Mutt Rescue 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 application and 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 Texas.
I make the above statements and voluntarily enter into this agreement to provide a temporary home as a foster caregiver to any animals Cypress Lucky Mutt Rescue may temporarily place in my care.
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