Request edit access
Foster Home Application & Waiver
PHOTO ID REQUIRED-TARZAN'S SAFE HAVEN MUST KEEP A COPY
Full Name & Age *
Your answer
Names & Ages of Everyone in the Household *
Your answer
Address *
Your answer
All phone numbers *
Your answer
Email *
Your answer
Employer Name & Occupation *
Your answer
Emergency Contacts & Phone Numbers *
Your answer
Valid Driver License Number *
Your answer
Will you consent to a background check? *
Do you live in a house or apartment? If renting can you provide proof the landlord will approve animals? *
Your answer
List all current pet(s) including breed, age, sex, medical and behavioral issues *
Your answer
Are your pet(s) spayed/neutered *
Are your pet(s) up to date on all their vaccinations? *
Will your pet(s) take well to new animals in the home? *
Your current veterinarian name & number. Can we contact them? *
Your answer
Are you willing to allow Tarzan's Safe Haven staff or volunteer visit your home? *
Is there anything special about you, your home, the other individuals living with you, or your residential pet(s) we should know? *
Your answer
What type of animals are you interested in fostering? *
Required
How did you hear about our foster program? *
Your answer
Have you ever fostered before? *
If yes, explain your experiences
Your answer
If no, why do you want to foster now and any previous experience with animals that lead to this decision
Your answer
Do you have room in your household to keep foster animals separate from your residential pet(s)? *
Do you have a fenced yard? *
Tarzan's Safe Haven is a non for profit organization and our supplies are received on donations. Are you able to provide supplies to your foster animal to insure their health and safety? *
If your foster animals need medical attention are you able and willing to transport them to our veterinarian? *
Will you consent for photo usage of you and your family to be used for awareness purposes at the digression of Tarzan's Safe Haven? *
Tarzan's Safe Haven Foster Home Policy & Waiver
Type Your Full Name As A Digital Signature of Acceptance
Your answer
I hereby agree to accept a position as a foster home in a volunteer capacity. I understand that by volunteering my time and home for Tarzan's Safe Haven as a foster home I choose freely to render services to Tarzan's Safe Haven with charitable motives and will not receive compensation *
I agree that when taking in an animal to foster for Tarzan’s Safe Haven, I will maintain possession of that animal for the duration of their foster time. If for any reason I am unable to complete my foster home duties or have found a better suitor for the foster animal, I will immediately inform Tarzan’s Safe Haven and make arrangements to bring the animal back to the Animal Rescue to be placed with their new foster home. I will not give an animal to another party without the Animal Rescue’s knowledge and consent. *
I agree to allow Tarzan’s Safe Haven to send staff or volunteers to visit my home and observe where the foster animal will reside while in my care separate from my residential pets. *
I agree to keep foster animals away from my own pet to insure the health and safety of all animals. If I fail to do so I assume all responsibility of all additional medical expenses to my residential pets and to the foster animal in my care and will not hold Tarzan’s Safe Haven liable. *
I agree to return the foster animal back to the Animal Rescue upon the request of Tarzan’s Safe Haven within 24 hours. *
I agree to keep the foster animal for the duration of the foster time deemed necessary by the veterinarian and the Animal Rescue in order to keep the animal safe and health in order for them to be ready to placed in their forever adopted home. *
I agree to transport the foster animal back to the Animal Rescue or veterinarian office for any reason including but not limited to vaccinations, checkups, blood tests, return for adoption. If I cannot make a scheduled appointment I will contact Tarzan’s Safe Haven immediately and reschedule as quickly as possible. *
If an animal gets sick I will call Tarzan’s Safe Haven and bring the animal in as soon as possible to be examined by the veterinarian. I agree to provide the foster animal with the necessary medication and treatment provided by the veterinarian. *
I will assume all financial responsibility if I bring the foster animal to any veterinarian other the veterinarian used by Tarzan’s Safe Haven unless approved by the Animal Shelter. *
I agree that my foster animals are Tarzan’s Safe Haven animals and that I will bring them in on schedule and agree to any medical decisions the veterinarian finds the most valuable for my foster animal. *
I agree to follow recommendations of the veterinarian, if the situation should arise that the foster animals are deemed unfit for adoption and must be euthanized. I understand that my consent is not to be obtained. *
The word volunteer is used as a volunteer foster home from this point on.
Waiver and Release: I, the volunteer, release and forever discharge and hold harmless Tarzan’s Safe Haven and its associates from any liability, claims, and demands of whatever kind or nature, either in law or in equity, which arise or may hereafter arise from my volunteer work. I understand that this agreement discharges Tarzan’s Safe Haven from any liability or claim I may have against Tarzan’s Safe Haven including bodily injury, personal injury, illness, death, or property damage that may result from participating as a volunteer with Tarzan’s Safe Haven. *
Insurance: I understand that Tarzan’s Safe Haven does not assume any responsibility or obligation to provide me with financial or other assistance, including but not limited to medical, health, or disability benefits or insurance of any nature in the event of injury, illness, death or property damage. I waive any claim for any compensation or liability on the part of Tarzan’s Safe Haven. *
Medical Treatment: I hereby release and forever discharge Tarzan’s Safe Haven from any claim whatsoever which arise or may hereafter arise on account of any first-aid treatment or other medical services rendered in connected with an emergency during my volunteer hours with Tarzan’s Safe Haven. *
Assumption of Risk: I understand that as a volunteer with Tarzan’s Safe Haven may include activities that may be hazardous to me including but not limited to, handling animals, construction activities, loading and unloading heavy materials, and off site fundraising and adoption activities. As a volunteer, I assume risk of injury or harm during these and other activities and will not hold Tarzan’s Safe Haven liable. *
Volunteer Understanding: I do hereby acknowledge that my volunteer work is of free will and I do not expect to receive any offer of employment, benefits, or compensation from Tarzan’s Safe Haven. *
Photographic Release: I do hereby grant and convey to Tarzan’s Safe Haven the right, title and interest in any and all photographic images and video or audio recording made by Tarzan’s Safe Haven. *
Individual Responsibility: I understand that it is my responsibility to conduct myself within the confines of all applicable federal, state, and local laws during my time volunteering with Tarzan’s Safe Haven. I understand it is my responsibility to be familiar with and follow all Tarzan’s Safe Haven policies, procedures, and other relevant documentation. I also understand it is my responsibility to immediately notify a Tarzan’s Safe Haven employee if I witness or participate in any activity that goes against the law, policy, or anything that may jeopardize the safety or wellbeing of myself, any animal or any other persons. I recognize that Tarzan’s Safe Haven will not be held liable for anything illegal, illicit activities, unsafe work procedures and conditions, abuse or neglect to the animals, ect. I also understand that any connection with me to these instances will result in my immediate dismissal as a volunteer. *
Confidentiality: I do acknowledge that during my time as a volunteer with Tarzan’s Safe Haven, I may have access to confidential information not generally known to the public concerning the business and daily procedures of Tarzan’s Safe Haven. I do hereby agree that during my time as a volunteer and forever after I will hold all confidential information in strict confidence and will not disclose or use such information outside the scope of my volunteer service. I also agree that all information I may posses during my time as a volunteer will be immediately returned to Tarzan’s Safe Haven when my job has been complete or in the event of me no longer associated with Tarzan’s Safe Haven. *
Other: I understand that policies and procedures may change throughout time. I agree to take the responsibility to keep up with all new policies and procedures. I understand my behavior must be professional, polite and utilize common sense at all times and always understand the animals come first. *
I ACKNOWLEDGE THAT I HAVE READ AND FULLY UNDERSTAND THE TERMS AND CONDITIONS OF THE FOREGOING VOLUNTEER WAIVER AND RELEASE AND THAT I WILL COMPLY WITH THE SAME. Please Type Your Full Name As A Digital Signature of Acceptance and Date Below *
Your answer
Next
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Additional Terms