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Application to Foster

Date*

Month

Day

Year

Name*

Multi-line address

Country/Region*

Address*

City*

Zip / Postal code*

Phone*

Email*

Emergency contact (name and phone):*

Able to foster:*

Dog

Cat

Both

Any Limitations:

Birthday*

Month

Day

Year

Drivers License #*

List all family members that will be living with the animal (name, relationship, date of birth):*

Is anyone in your home allergic to animals?*

Yes

Do you live in a:*

House

Condo

Apartment

Other

Do you have your landlord's written permission to foster an animal?*

Yes (or not applicable)

Are you comfortable giving medication?*

Yes

How many hours of the day are you usually away from home?*

Current veterinarian name, phone and address:*

May we conduct an initial home visit?*

Yes

Do you agree to home visits to check on foster animal?*

Yes

Please list and describe all pets, including barnyard animals living with you. Type, age, spayed/ neutered, up to date on vaccines.

Please check that you understand the following:

Fosters are expected to care for the foster animal for the time agreed upon. Foster animals are to be

kept clean and sanitary for their health and wellbeing. If an emergency arises, medical or otherwise, please

contact COMPANION ANIMAL CARE OF BREVARD COUNTY, INC. immediately so medical care can be

arranged.

By signing this form, I/We are confirming all information is correct.

I/We have read and fully understand the expectations, and understand there have been no other

representations or promises other than those included in the Pet Foster Application.

I/We understand that all foster and volunteer work is at my/our own risk.

I/We understand that cats are indoor only.

Legal ownership of all animals remains with COMPANION ANIMAL CARE OF BREVARD COUNTY, INC.

until such time as proper adoption is completed. Only authorized representatives of COMPANION ANIMAL

CARE OF BREVARD COUNTY, INC. will conduct adoption interviews and process adoptions, transfers, or

relinquishments. Fosters are expected to comply with the adoption process. If a foster home decides to

adopt the animal, the regular adoption fee applies. If a foster finds a suitable adoptive home for their animal,

they will contact COMPANION ANIMAL CARE OF BREVARD COUNTY, INC. and the adopter will go through

the application and home visit process.

I/ We have read, understand and agree to abide

by the conditions of the Pet Foster Application Agreements & Guidelines. I/we understand that all work

done pursuant to this Foster Agreement is at my/our own risk, and I/we assume such risk freely and

voluntarily. I/we hereby release COMPANION ANIMAL CARE OF BREVARD COUNTY, INC. and its agents and

employees of all liability, property damage, and medical costs while I/we am/are providing volunteer foster

care for COMPANION ANIMAL CARE OF BREVARD COUNTY, INC. I/We, hereby for myself (ourselves), heirs,

administrators and assigns, fully, irrevocably and unconditionally release and agree to hold harmless

COMPANION ANIMAL CARE OF BREVARD COUNTY, INC. and its individual members from any and all

known or unknown, anticipated or unanticipated, suspected or unsuspected causes of action, charges, suits,

debts, demands, claims, liabilities, losses, costs, expenses (including with our limitation, attorneys' fees) or

damages, including but not limited to any medical costs, damage to property, persons or other pets, of any

and every kind, nature and description, at law or in equity, in connection with or arising from while I am

caring for the agreed rescue companion animal.

Printed name*

Signature*

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Companion Animal Care (CAC) of Brevard County, FL ministers to those living on the Space Coast.

We are an approved I.R.S. 501(c)3 tax exempt nonprofit.