Foster Agreement Dog - Southern Tier Animal Control Southern Tier Animal Control

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Input Your Full Name below this applies to you accepting. I,(full name), make the following statements and voluntarily enter into this Foster Care Agreement (hereinafter"Agreement") to provide temporary care as a foster caregiver for Southern Tier Animal Control (hereinafter "STAC")

I have never been convicted of animal cruelty, neglet, or abandonment. I agree to notify STAC if I am convicted of animal cruelty, neglect or abandonment in the future. Initial agree or disagree in the following box.

I agree to comply with all other federal, state and local laws that pertain to compnaion animals and per ownership in the jurisdiction where I reside. Initial agree or disagree in the following box.

Initial to Initial

I understand that STAC reserves the right to check on the welfare of my foster animal, which may include a visit to my foster home. I further understand that if STAC finds a direct and immediate threat to my foster animal, STAC may remove the animal from my care. Initial agree or disagree in the following box.

I acknowledge that I have received a copy of the STAC Foster Care Manual ("Manual") and that i have read the Manual. I agree to fully comply with the policies, guidance and requirements set forth in the Manual as applicable to my foster animal. Initial agree disagree in the following box.

I agree to not take my foster dog(s) or my foster cat(s0 to dog parks, off-leash areas, daycare facilities, crowded public areas, or any similar locations, unless give prior approval by STAC Foster Coordinator. I understand that I will be solely responsible for any injury or damage caused by my foster animal if I do not comply with this provision. Initial agree or disagree in the following box.

i understnad that STAC recommends that my foster animal(s) is to be kept separate from any other animals currently living in my home. I agree that if I choose to intrduce my foster animal(s) to any other animal living in my home, I will be solely responsible for any illness or injury to other animals. Initial agree or disagree in the following box.

I agree tha the anumal(s) that i foster will reside in my home, will be kept as household pets, and will not be used for breeding. Initial agree or disagree in the following box.

I agree to notify the STAC Foster Coordinator immediately by phone and in writing at 607-333-0563 and southerntieranimalcontrol@gmail.com immediately if my foster animal(s) becomes lost or separated from me. Initial agree or disagree in the following box.

I agree to notify the STAC Foster Coordinator immediately by phone and in writing at 607-333-0563 and southerntieranimalcontrol@gmail.com immediately if my foster animal(s) demonstrates any aggressive behavior, including, but not limited to biting a person or another animal. Initial agree or disagree in the following box.

I agree to seek immediate medical attention if I am bitten by my foster animal, or if I receive any other physical injury resulting from interaction with my foster animal. I further agree to seek immediate medical attention for any member of my household who is bitten or suffers any other physical injury resulting from interaction with my foster animal. Initial agree or disagree in the following box.

I agree to return my foster animal(s) at any time upon request of the STAC Foster Coordinator or any STAC staff member. Initial agree or disagree in the following box.

I agree to receive and respond to calls and emails concerning my foster animal(s) from STAC Foster Care Provider Agreement shelter staff, veterinary staff, and potential adopters. Initial agree or disagree in the following box.

I agree to transport the animal to STAC or an approved verterinary clinic to receive medical treatment as requested by the STAC Foster Coordinator or STAC staff. If my foster animal experienced a medical emergency. I agree to follow the instructions outlined under "In Base of an After Hours Emergency" in Manual. Initial agree or disagree in the following box.

I understand that STAX will nor reimburse me for any routine or nonemergency care for my foster animal that is not pre-approved in writing by the STAC Foster Coordinator. Initial agree or disagree in the following box.

I agree to contact the STAC Foster Coordinator at 607-333-0563 or southerntieranimalcontrol@gmail.com for any other emergency or non emergency matters Initial agree or disagree in the following box.

I agree to assume the risks implicit in working with animals who may have been abandoned, neglected, mistreated, or who may suffer from an illness or disease. My participation in the STAC Foster Program is entirely voluntary and without the promise or expectation of compensation. I have no known physical or mental condition that would impaire my ability to partipate in the STAC Foster Program. I understand tha while STAC staff carefully monitors all animals, STAC may have limited knowledge of their behavioral and medical backgrounds. Therefore, I undestand that STAC makes no warranties or representations regarding my foster animal's health, behavior, temperament, age or breed. I further understand that environmental changes may affect and change the temperament of my foster animal(s). Initial agree or disagree in the following box.

I understand and agree that STAC members, officers, directors, agents and elected officials have no liability or responsibility of any nature for injuries or damage to any person, animal or property which may be caused by my foster animal(s) or my participation in the STAC Foster Program. I, for myself and my heirs, executors, administrators and assigns, hereby release, indemnify and hold harmless STAC, its members, officers, directors, agents, elected officials, and their heirs, administrators, executors, successors, and representatives from all liability for and all risk of damage or bodily injury or death that may occur to me including any injury based on negligence) now or hereafter in connection with my foster animal(s) and my participation in the STAC Foster Program. I expressly agree that this release waiver and indemnity is intended to be as broad and inclusive as permitted by the State of New York and that if any portion is held invalid, the remainder shall continue in full force and effect. Initial agree or disagree in the following box.

By my signature below and, by my initials on each paragraph above, I affirm that all statements and stated agreements contained in this document and truthful. I affirm that I have read and understand this Agreement in its entirety, and I agree to abide by the terms of this Agreement. Initial agree or disagree in the following box. Also date the below signature

This signature is for Shelter Manager/Representatives signature and date