STACY SMITH ANIMAL

COORDINATOR & FOUNDER 

​916.899.0877

PET INFORMATION

Pet’s Name

Breed Sex Age
Color and Description

Spayed/Neutered

ID Tag #

Rabies Tag #

Microchip #

Medical Record Given Date


Foster Period Begins

FOSTER CARE PROVIDER INFORMATION

Foster’s Name

Address
City

State

Zip Code

Home Phone

Cell Phone
Email
Driver’s License #


I, THE FOSTER CARE PROVIDER, AGREE TO PROVIDE FOSTER CARE FOR THE PET NAMED ABOVE (“PET”) FROM 2 HEARTS ANIMAL HAVEN (“2HAH”) AND AGREE TO ALL OF THE FOLLOWING CONDITIONS DURING THE FOSTER CARE PERIOD.

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I. FOSTER CARE THE PET MUST BE TREATED AS AN INDOOR PET: I agree to treat the Pet as an indoor pet and household companion, not as an outdoor pet. This means that the Pet must be kept inside the home in a safe place at all times. The Pet cannot be left outside while unsupervised unless 2 Hearts Animal Haven (“2HAH”) has given prior written approval.

THE PET MUST BE PROVIDED A SAFE ENVIRONMENT AT ALL TIMES: I agree to keep the Pet either safely crated or safely inside the home and separated from other animals while I am not at home or am unable to supervise the Pet.

3. THE PET MUST BE PROVIDED PROPER TREATMENT: I agree to provide the Pet with humane treatment at all times. This means providing the Pet with proper food, fresh water, proper shelter and exercise, and allowing a reasonable amount of time for the Pet to adjust to new surroundings.

4. THE PET CANNOT BE SOLD OR TRANSFERRED: I agree NOT to give or sell the Pet to another person, relative or any other individual, or any rescue group, humane association, shelter or pound, or any medical or experimental laboratory or any organization. In the event that the Pet is lost or stolen, I agree to make every reasonable effort to recover the Pet.

5. THE PET’S APPEARANCE CANNOT BE ALTERED: I agree NOT to alter the Pet’s appearance in any way, shape or form (e.g. cropping, docking) except for routine grooming.

6. 2HAH HAS THE RIGHT TO MAKE PERIODIC VISITS: I agree to allow any 2HAH representative to make periodic visits to my home during the foster care period.

7. 2HAH HAS THE RIGHT TO REQUEST THE RETURN OF THE PET: I agree to immediately return the Pet in good condition to 2HAH if at any point, for any reason, 2HAH requests that I surrender the Pet.

8. 2HAH MUST BE NOTIFIED UNDER CERTAIN CIRCUMSTANCES: I agree to immediately notify 2HAH under the following circumstances:

(1) If I change address, change telephone number or move.

(2) If I plan to travel with or without the Pet.

(3) If I am no longer able to continue to provide care for the Pet.

(4) If the Pet is lost or stolen.

(5) In the event of the Pet’s death or serious illness.

(6) For any other reason or circumstance concerning the proper care of the Pet.

9. THERE IS NO REPRESENTATION AS TO TEMPERAMENT OF THE PET: I agree that there is no guarantee of any kind as to the temperament of the Pet. 2HAH, its agents and employees make no representation or guarantee of any kind, either explicitly or implicitly, as to the temperamental or mental disposition of the Pet.

10. INDEMNITY AGREEMENT – I AGREE TO HOLD 2HAH HARMLESS: I agree to foster the Pet at my own risk, and indemnify and release 2HAH, including its officers, directors, volunteers and employees, of any and all liability arising from damages to person(s) or property caused by the Pet. I agree to hold 2HAH free and harmless from any loss or liability, of any nature whatsoever, arising out of or in any way connected to the foster care of the Pet and/or the performance of this Foster Care Agreement, including loss or liability caused by the Foster Care Provider’s own negligence.

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II. COSTS DURING FOSTER CARE

1. THERE IS NO FEE FOR THE FOSTER CARE OF THE PET: Foster Care Provider is NOT entitled to any fee or payment for the foster care of the Pet. Any and all costs associated with the care of the Pet are completely the responsibility of the Foster Care Provider unless otherwise specified in this contract.

2. VETERINARY EXPENSES FOR THE PET CAN BE PROVIDED BY 2HAH: 2HAH will only cover veterinary expenses for the Pet if (1) the veterinary care is pre-approved by the 2HAH director and (2) the veterinary care is performed by a 2HAH authorized veterinarian. If the Foster Care Provider is unable to meet these two requirements, for any reason including an emergency situation, then it is in the sole discretion of 2HAH whether to cover these expenses.

III. END OF FOSTER CARE

1. WHAT TO DO IF YOU DECIDE TO PERMANENTLY ADOPT THE PET: 2HAH continues to work on the proper placement of our animals and would love for each and every Pet to find the proper home. In the event that the Foster Care Provider wishes to permanently adopt the Pet past the Foster Care period, then the Foster Care Provider must:

(1) Notify 2HAH Foster Care Provider must notify 2HAH and must follow 2HAH’s established adoption procedures including the payment of required adoption fees. An adoption request is not a guarantee and must be approved by 2HAH. All donations received in connection with the adoption of the Pet will only be received by2HAH.

(2) Continue Proper Foster Care for the Pet: During the Period between the adoption request and adoption approval, all terms of this Foster Care Agreement will continue to apply and Foster Care Provider must continue to provide proper care for the Pet.

(3) Return Crate to 2HAH (Mark As Applicable) Y or N : A crate belonging to 2HAH has been loaned to the Foster Care Provider and will be returned when the Pet is returned or adopted. Failure to return the crate will result in a charge of $100.

2. WHAT TO DO IF YOU DECIDE TO RETURN THE PET: In the event that the Foster Care Provider wishes to return the Pet to 2HAH either prior to or at the end of the Foster Care period, the Foster Care Provider must:

(1) Notify 2HAH at Least 5 Business Days Prior to Return: Foster Care Provider may end this agreement at any time, but must give 2HAH at least 5 business days to make other foster arrangements. Any boarding costs incurred during this 5-day period are the responsibility of the Foster Care Provider.

(2) Return the Pet in Good Condition: The Pet must be returned in good condition as required under this agreement. If the Pet is not returned in good condition, then 2HAH has the right in its sole discretion to charge the Foster Care Provider for any expenses required to return the Pet to good condition.

(3) Return Crate to 2HAH (Mark As Applicable) Y or N : A crate belonging to 2HAH has been loaned to the Foster Care Provider and will be returned when the dog is returned or adopted. Failure to return the crate will result in a charge of $100.

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I, THE FOSTER CARE PROVIDER, HAVE READ AND FULLY UNDERSTAND THE TERMS AND CONDITIONS OF THIS FOSTER CARE AGREEMENT, AND AGREE THAT IT IS NOT ARBITRARY AND THAT THE PROVISIONS HEREIN ARE COMMON IN PET FOSTER CARE AGREEMENTS. I FURTHER UNDERSTAND AND AGREE THAT IF I FAIL TO COMPLY WITH ANY OF THE TERMS OF THIS FOSTER CARE AGREEMENT, THAT PW HAS THE RIGHT TO RECLAIM THE PET, AND TO ENFORCE THIS CONTRACT IN A COURT OF LAW.

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PRINTED NAME OF FOSTER CARE PROVIDER

X____________________________________ _____________

SIGNATURE OF FOSTER CARE PROVIDER DATE

X____________________________________ _____________



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PERMISSION TO USE PHOTOGRAPH / LIKENESS

Purpose or event: Foster Care of 2HAH Pet

I grant to 2 Hearts Animal Haven, its representatives and employees the right to take photographs or video of me and any of my pets, in connection with the above-identified purpose or event. I agree that 2 Hearts Animal Haven may use these photographs or video with or without my name and for any lawful purpose including, but not limited to, publicity, commercial use, illustration, advertising and web/social media content. I authorize 2 Hearts Animal Haven, its assigns and transferees to copyright, use and publish these images in print and/or electronically.

I waive the right to any financial compensation in connection with these photographs or video.

I have read and understand the terms detailed above.

Signature _______________________________________Date ___________

(parent or guardian if under 18)

Printed name _______________________________________________________ 



APPLICANT MUST PRINT THIS APPLICATION, SIGN AND DATE, AND SUBMIT TO info@2heartsanimalhaven.org

FOSTER QUALIFICATION APPLICATION