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Chicagoland Shepherd  Rescue

Foster Care Information & Agreement


Foster Care Party's Information Sheet
Exhibit A

Name: _______________________________________________

Address:______________________________________________

City:___________________________________ State:_______________________ Zip:_____________

Do you: ____Own a home ____Rent a home (Landlord phone:__________________________)

Home Phone:__________________________ Work Phone:_____________________________

Employer:______________________________________________ City:______________________________

Occupation:______________________________________________ Typical Hours Worked:______________

Other Adults in the home (name/relationship):______________________________________________________

Number of children in the home:________ Ages:___________________________

Your previous experience with dogs:
______________________________________________________________________________________

Pets in your home:
Number, sex, breeds, and ages of dogs:________________________________________________________
Number of cats: ______________
Number and types of other pets:______________________________________________________________

Do your pets live: ___Inside ___Mostly inside ___Mostly outside ___Outside

Are your dogs housetrained? ___Yes ___No

List any behavior problems your dogs have:_______________________________________________________

Have any of your dogs ever bitten anyone? ___Yes ___No
If yes, please describe:_______________________________________________________________________

What brand of food do you feed your dog?_______________________________________________________

How often do your dogs eat?_________________________________________________________________

Your vet's name:___________________________ City:______________________ Phone:________________

When were your dogs last tested for heartworm?  Month:_________________ Year:______________

Are your dogs current on heartworm preventive? ___No ___Daily ___Monthly

When were your dogs last vaccinated for:
Distemper/Parvo (date):_______________________
Rabies (date):__________________________
Bordatella (date):_________________________
Lyme Disease (date):________________________

Do any of your pets have any serious/chronic health problems? ___Yes ___No
If yes, describe:__________________________________________________________________________

May we call your vet to verify this information? ___Yes ___No

Please list 3 references along with their phone numbers: ____________________________________________
_____________________________________________________________________________________

How do you discipline your dogs? ____________________________________________________________

Are your dogs obedience trained? ___No ___Yes  If yes, trainer's name:___________________________

Why are you interested in becoming a foster home?
_______________________________________________________________________________________

What types of dogs are you willing to foster? (check all that apply)
___Females ___Males ___Adults ___Puppies ___Dogs from animal shelters ___Dogs from private owners ___Injured/sick dogs ___Abused/neglected dogs

Are you comfortable with: (check all that apply)
___Bathing a dog ___Grooming a dog ___Housetraining a dog ___Shy dogs ___Stand-offish dogs ___Active dogs ___Clipping toenails ___Giving medications

Is your yard fenced? ___Yes ___No
If yes, height of fence:_____________ material:_____________________________

Check all that you own:
___dog crate(s) If so, type: ___plastic ___wire Size(s)_________________________________
___grooming clippers ___grooming table ___flexible leash ___heating pad

Number of daily walks able to give a dog:___________ Approximate distance:____________________

Are you able to drive distances to pick up a dog? ___Yes ___No
If yes, make of car:_______________________________________

Have you ever been a party in a civil suit? ___Yes ___No
If yes, describe:__________________________________________________________________

Do you have any health problems which might affect your fostering ability (example: cannot lift dogs over 50lbs due to back problem):
_____________________________________________________________________
_____________________________________________________________________________

Other comments: ________________________________________________________________
_____________________________________________________________________________
 
 



Foster Care Agreement

Whereas the Chicagoland Shepherd Rescue, Inc (hereinafter referred to as "Rescue Society") is a non-profit organization with the principle purpose of providing dog rescue to German Shepherd Dogs; and

WHEREAS _________________________________(name of Foster Care Party) (hereinafter referred to as "Foster Care Party") is a person or are persons residing at ________________________________________________ who wishes/wish to provide a foster care home for the dog(s) in Chicagoland Shepherd Rescue, and

WHEREAS this agreement is being entered into for the benefit of the Chicagoland Shepherd Rescue dog(s), and

WHEREAS the parties make certain representations herein that they understand that the other party hereto will rely on

IT IS HEREBY AGREED by and between the Rescue Society and Foster Care Party as follows:

   1.Representations by Rescue Society.
     (a) That Rescue Society has obtained the dog(s) to be fostered in this agreement in a legal and lawful manner and that said Rescue Society has full authority to deliver said dog(s) to the Foster Care Party.
     (b) That said dog(s) is/are being delivered to Foster Care Party for temporary period of time pending a disposition of a permanent placement with a person or entity other than Foster Care Party.
   2.Representations by Foster Care Party.
     (a) That Foster Care Party has never abused, neglected or mistreated any dog or animal.
     (b) That Foster Care Party has never been accused of a violation of any state statute, or local ordinance making it a crime or civil infraction to abuse, neglect, or mistreat any dog or animal.
     (c) That the information contained in EXHIBIT A [FOSTER CARE PARTY'S INFORMATION SHEET] is true and accurate.
     (d) That Foster Care Party has been informed, knows, and acknowledges that the fostered dog(s) is/are not being permanently placed with Foster Care Party and that at the request of Rescue Society, Foster Care Party will be required to return said dog to Rescue Society for any reason.
   3.Rescue Society agrees as follows:
     (a) To make the following clinic or such other clinic as Rescue Society shall give Foster Care Party notice of in writing, available, upon appointment or notice given in the event of an emergency, for necessary medical care for the fostered dog(s).
     ___________________________________________
     ___________________________________________
     ___________________________________________
     (b) To retake possession of the fostered dog(s) at the time during regular business hours that Foster Care Party wishes to return the fostered dog(s).
     (c) To retake possession of the fostered dog(s) upon disposition of the matter for which the fostered dog(s) is/are held.
   4.Foster Care Party agrees as follows:
     (a) To allow for the inspection, by agents of Rescue Society, of premises upon which the fostered dog(s) will be maintained for the purposes of determining the suitability of those premises for the care and maintenance of the dog(s) being fostered.
     (b) To, upon approval by Rescue Society, take possession of the dog(s) in need of fostering.
     (c) To provide the fostered dog(s) food, drink, shelter, and needed medical attention through a clinic designated by Rescue Society so as to maintain the dog(s) in good health, to notify Rescue Society of any change in the dog(s) health, to act in compliance with the state's anti-cruelty laws and any similar local ordinance.
     (d) To at all times, adequately and safely confine the fostered dog(s) so that the fostered dog(s) does/do not wander or stray from the care of the Foster Care Party, to refrain from delivering said dog(s) to any other person(s) or entities without the prior written consent of Rescue Society, and to immediately notify Rescue Society if the whereabouts of said dog(s) be at any time unknown.
     (e) To notify Rescue Society in the event that any change occurs in Foster Care Party's address or telephone number, or in the event any fact arises which disrupts the continued proper care of the fostered dog(s).
     (f) To allow Rescue Society to view the fostered dog(s) and the premises referred to in paragraph 4(a) at any reasonable hour during the period of foster care to determine the health of the fostered dog(s) and to view the circumstances surrounding the fostered dog's care.
     (g) To permit Rescue Society to retake possession and personal custody of the fostered dog(s) at any time and for any reason (including disposition of the matter for which the fostered dog(s) is/are being held), and to pay all of Rescue Society's costs and reasonable attorney fees that may be incurred by the Rescue Society in seeking the return of the fostered dog(s) for the reason of Foster Care Party's failure to return said dog(s) upon the request of Rescue Society.
     (h) That Foster Care Party has homeowner's personal liability insurance coverage in an amount of $100,000.00 / $300,000.00.
     (i) That Foster Care Party hereby releases and waives any claim or cause of action that Foster Care Party may hereafter have against Rescue Society for any injury caused by said dog(s) to Foster Care Party and agrees to indemnify Rescue Society against any liability incurred by Society for any such liability incurred by Rescue Society as a result of a claim or cause of action brought by Foster Care Party. Foster Care Party's family and invitees to Foster Care Party's home against Rescue Society, relating to said dog(s).

IN WITNESS WHEREOF, I have hereunto set my hand this ____ day of _________________, 20____.
 

                                                                          _______________________________________

                             Chicagoland Shepherd Rescue

                                                                          _______________________________________
                                                                                                    Foster Care Party
 
 



Fostering Release and Indemnity Agreement

The undersigned Fostering Party does hereby forever release, discharge and covenant to hold harmless the Chicagoland Shepherd Rescue and any other person, firm, or corporation charged or chargeable with responsibility or liability, their heirs, administrators, executors, successors and assigns, from any and all claims, damages, costs, expenses, lost of services, actions and causes of action belonging to the said Fostering Party arising out of any act or occurrence for the present time, and particularly on account of the fostering of any German Shepherd for Chicagoland Shepherd Rescue.

By signing this document, the Fostering Party hereby declares: that no representations about the nature of said dog, nor any representations regarding the nature and extent of legal liability or financial responsibility have induced the Fostering Party to make this Release and Indemnity Agreement.

THE UNDERSIGNED hereby further agrees to abide by the "Terms of Fostering" listed below:

I . Neutering. Fostering Party agrees that under no circumstances will this dog be used for breeding purposes if not neutered/spayed before placement in foster home with Fostering Party. Fostering Party agrees to keep females in heat away from male dogs.

2. Return. If for any reason, the foster situation is not satisfactory to Fostering Party, or if Fostering Party fails to comply with all the terms and conditions of this Agreement, or if any misrepresentations have been made by the Fostering Party, the dog must be returned to Chicagoland Shepherd Rescue Inc. immediately upon request without legal writ or order. Foster dog must be in as good or better mental and physical condition as on the date of initial fostering ("condition" as determined by Chicagolans Shepherd Rescue Directors). If said dog is returned in worse condition than as on date of initial fostering (as determined by Chicagolans Shepherd Rescue Directors), Fostering Party agrees to pay for costs of returning dog to condition as of date of initial fostering.  Chicagoland Shepherd Rescue will accept return of said dog for any reason. Fostering Party must notify Chicagoland Shepherd Rescue by phone first and then in writing to the Chicagoland Shepherd Rescue address below of the need to return foster dog, and state the reason why. Fostering Party agrees to allow Chicagoland Shepherd Rescue up to one (1) weeks notice of the need to return foster dog if requested to do so to allow Chicagoland Shepherd Rescue to make other arrangements for foster dog in that time period. The Start Date of the one week notice is defined as the postage mark date on the written notice to Chicagoland Shepherd Rescue regarding the need for return. Fostering Party agrees in this case to retain foster dog for (up to) that one extra week, at Fostering Party's expense, at which time Chicagoland Shepherd Rescue will take foster dog. Fostering Party recognizes that Chicagoland Shepherd Rescue will make every effort to remove foster dog from Fostering Party as quickly as possible, but has through the defined one week to do so. Fostering Party agrees to be responsible for any expenses incurred in the dog's return, including shipping, and is responsible for returning dog to Intake Facility or other spot designated by a Chicagoland Shepherd Rescue Director.

Chicagoland Shepherd Rescue retains the right to reclaim said dog if dog does not integrate properly into Fostering Party's household as determined by Chicagoland Shepherd Rescue. Fostering Party agrees to relinquish custody of said dog to Chicagoland Shepherd Rescue representatives immediately upon request without legal writ or order if so requested by the Chicagoland Shepherd Rescue Directors, for any reason.

3. Transfer of Ownership. The dog may not be transferred to any other person, firm or corporation for any reason whatsoever. Chicagoland Shepherd Rescue must be notified upon the death of said rescue dog within 24 hours of death. Fostering Party agrees to contact Chicagoland Shepherd Rescue if said dog is lost for more than 12 hours.

4. Care. It is understood that foster dog will be kept as a house dog, not a kennel or yard dog and that the dog will not be kept chained or on a tie-out unsupervised at any time. Foster dog must NEVER be allowed to roam free in an unfenced area without supervision. Foster dog must be placed on an inoculation and heartworm preventative program as established by the Chicagoland Shepherd Rescue's veterinarian in order to guarantee continued health of foster dog. Fostering Party assumes all responsibility for said dog including but not limited to general well-being, but excluding food and health care as defined in this Agreement.

Fostering Party agrees to allow Chicagoland Shepherd Rescue to periodically check dog's acceptance of the new environment and family at anytime during the fostering time and to ensure the Fostering Party's compliance with the Terms of Fostering. Chicagoland Shepherd Rescue retains the right to reclaim said dog when warranted because of neglect, abuse, inadequate care as defined by Chicagoland Shepherd Rescue Directors, or breach of contract. Fostering Party agrees to relinquish custody of said dog to Chicagoland Shepherd Rescue representatives immediately upon request without writ or legal order.

5. Foster Upkeep. Fostering Party agrees to follow EXACT instructions given by Adoption Coordinator for each as to the care, treatment, training, and general foster home experience for Rescue foster dog. This includes instructions to keep dog on leash at ALL times unless in a safely fenced area, to follow safety procedures in socialization with humans and other dogs, etc. Fostering Party agrees to send truthful, full reports on any subject related to said dog, to Foster Home Coordinator, upon request.

6. Training. Absolutely, under NO circumstances may Fostering Party employ the so-called "alpha roll" technique (as described in the book How to Be Your Dog's Best Friend by the Monks of New Skete) on Rescue foster dog. Chicagoland Shepherd Rescue requests that Fostering Party train Rescue foster dog in basic training of commands such as sit, down, wait, and come. Only training methods approved by Chicagoland Shepherd Rescue may be employed on Rescue foster dog.

I, the Fostering Party, understand that I may not ever employ "alpha rolls" on a Rescue foster dog and that doing so is in direct breach of this contract.
__________(please initial):

7. Value. Fostering Party and Chicagoland Shepherd Rescue agree that the value of this dog is $500.

8. Reimbursement. Chicagoland Shepherd Rescue will reimburse Fostering Party for health care expenses incurred by Fostering Party for foster dog's health during the foster placement period of time, if and only if health expenses are incurred at the veterinary facility approved in writing Chicagoland Shepherd Rescue before treatment commences; the only exception being if foster dog is in a life-threatening situation and needs immediate emergency care. Chicagoland Shepherd Rescue will provide a crate for Fostering Party only if one is available to loan out. Otherwise, Fostering Party must provide proper-sized crate or kennel run for foster dog. For reimbursement, Fostering Party must submit receipts for expenses to the Treasurer monthly at

     Chicagoland Shepherd Rescue
     PO Box 147
     Hines, IL 60141

Reimbursement will be made within 60 days of expense account submission, unless agreed upon otherwise by Chicagoland Shepherd Rescue and Fostering Party in writing, before expenses are incurred. Chicagoland Shepherd Rescue is not responsible for reimbursing Fostering Party for foster dog's items outside of health care or food, including, but not limited to: obedience classes, toys, beds, solutions for accidents in the house, etc. Reimbursement for behavioral help will be granted in writing at the discretion of a Chicagoland Shepherd Director after receiving a request for such from Fostering Party.

9. Foster Time Periods. Chicagoland Shepherd Rescue will make every effort to adopt out Rescue foster dogs to new homes as quickly as possible. However, Chicagoland Shepherd Rescue makes no claims as to the maximum duration of a particular fostering placement. Minimum foster home placement duration is 21 days for observation.

10. Adoption Appointments. Potential adopters will be sent to Fostering Party's home for dog visits only after being approved for adoption, and then visits will only be made by appointments known by Fostering Party, Adopter, and Chicagoland Shepherd Rescue before appointed time. Fostering Party agrees to make himself available for adoption appointments at least once a week during fostering periods. For first visit by Adopter, Fostering Party agrees to discuss foster dog with potential Adopter for up to an hour, and to allow safe contact with foster dog and specifically not Fostering Party's personal dogs, in Fostering Party's home or store. If Adopter would like his dog(s) to meet foster dog, Fostering Party agrees to instruct Adopters on how to conduct a meeting between Adopter's dog(s) and foster dog before conducting such a meeting. Fostering Party agrees to allow foster dog to meet Adopter's dogs one at a time in a neutral territory with both animals on a 6-ft leash with training or "choke" collars on both dogs for safety, with leashes each held by adults over 18 years of age.

Children should be allowed to meet foster dog only with supervision and instruction from Fostering Party and parent/guardian, and with the caution one would employ for any child meeting any strange dog. When Adopter's dog and foster dog meet, children must be away from the general meeting area. After first visit, Fostering Party agrees to call Chicagoland Shepherd Rescue to discuss his feelings on Adopter within 24 hours of visit. For Second visit,  Adopter may take foster dog home only after signing a contract which has previously been signed by Chicagoland Shepherd Rescue and at the time by Fostering Party (as a Chicagoland Shepherd Rescue witness), and upon inspection by Fostering Party that Adopter did not bring Adopter's dog(s) along for the trip home unless both dogs are crated in the vehicle, and that no child(ren) under 12 years is/are present without additional adult for supervision.

11. Telephone calls. Fostering Party agrees to keep all Rescue-related telephone consults with Chicagoland Shepherd Directors, Officers, and other Chicagoland Shepherd Rescue members to between the hours of 10:00 a.m. and 9:00 p.m., EST, except in the event of an extreme emergency.

12. Reservation of Rights. Chicagoland Shepherd Rescue reserves the right to follow through on this adoption in order to protect the welfare of the foster dog, as defined by Chicagoland Shepherd Rescue Directors. If the terms and conditions of this agreement are not upheld by Fostering Party, and/or if any misrepresentation have been made to Chicagoland Shepherd Rescue by said Fostering Party, Chicagoland Shepherd Rescue reserves the right to terminate this Agreement and Fostering Party must return foster dog to Chicagoland Shepherd Rescue upon request without legal writ or order. These rights are enforceable in law and in equity.

13. Photographic/Story Rights. Fostering Party agrees to allow Chicagoland Shepherd Rescue to print photographs/stories of Fostering Party and Chicagoland Shepherd Rescue foster dog in the Chicagoland Shepherd Rescue website. (Please initial choice): Yes No

14. Physical Attributes. Fostering Party will not alter physical characteristics of Rescue foster dog in any way except to clean foster dog's coat and ears, and clip said foster dog's nails. Fostering Party agrees to keep foster dog in appropriate clean, groomed condition to show to potential adopters.

15. Attorney Fees and Costs. Should it become necessary for Chicgoland Shepherd Rescue to take legal action to recover the Rescue foster dog or otherwise enforce the provisions of the Agreement, Undersigned Fostering Party agrees to pay all court costs and reasonable attorney's fees for Chicagoland Shepherd Rescue legal costs.

CHICAGOLAND SHEPHERD RESCUE AND ITS REPRESENTATIVES ACCEPT NO RESPONSIBILITY FOR DAMAGE OR INJURY CAUSED BY THIS GERMAN SHEPHERD RESCUE DOG OR GUARANTEE AS TO ITS PRESENT OR FUTURE MEDICAL CONDITION OR TEMPERAMENT.

If any part of this contract is deemed invalid, that shall not affect the validity of any other section of this Agreement and the remainder of Agreement will continue to be upheld. Party affirms that he is fostering said German Shepherd Rescue Dog and agrees to abide by the terms of this Agreement. By signing, Fostering Party is stating that each clause and the contract in its entirety has been read and understood by him. Fostering Party is signing of his own free will and not under duress of any kind. Fostering Party affirms that he has never been charged with animal cruelty, and is not an animal dealer or broker. The UNDERSIGNED understand that the parties hereby released admit no liability of any sort by reason of this adoption and that said payment is made to terminate further controversy respecting any and all claims for damages that said Fostering Party has heretofore asserted or might personally or through personal representative hereafter assert because of said adoption.

Fostering Party's
Name:
Date:

Fostering Party's
Signature:
Address:
City:
State:
Zip:
Home Phone:
Work Phone:

Chicagoland Shepherd Rescue Agent/Witness
Name:
Signature: