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2. Last Name*
3. First Name*
4. Middle Name
6. Address
8. City
9. State
10. Zip Code
12. Telephone*
13. Phone Type
    -- Select One --HomeCellWork
15. Email*
17. Emergency Contact Name*
18. Relationship*
19. Phone Number*
21. Current Employer*
22. Occupation*
24. Employer Address
25. City
26. State
27. Zip
29. What type of foster are you interested in? *

    1. Kittens
    2. Cats
    3. Puppies
    4. Dogs
    5. Other
30. Rent or Own? *

    1. Rent
    2. Own
    3. Live with family
31. Type of residence*

    1. House
    2. Townhouse
    3. Apartment
    4. Condo
    5. Other
33. If renting, name of landlord
34. Landlord Phone Number
36. Restrictions

    Please explain any restrictions you may have. Ex: fenced in yard or not, allergies, small children in home, living with an elderly person, breed restrictions in apartment

38. Veterinarian's Name*
39. Veterinarian's Phone Number*
41. Veterinarian's Address
43. City
44. State
45. Zip Code
47. Animals Currently Living on Property*

    Please list any and all cats and dogs currently living on the property, even if you are not the owner. 

49. Agreement

    A.  I hereby acknowledge that said transfer and assignment for fostering of said  animal is good and valuable consideration and that the Foster(s) covenants and agrees with the City of College Park with respect to the foster agency/personnel and the dog/cat as follows:

    1. If I am  unable to care for or keep the dog/cat, I will return it to the designated representative of the City of College Park.  I will not sell or give the dog/cat to another person, place it  in an animal shelter or humane society, or turn it loose to roam freely, or abandon it.

    2. I will properly house, feed, water, exercise, care for, and provide inoculations, and other veterinary or supportive care for the dog/cat, as required. I will maintain proper control over the dog/cat and not allow it to run at large.

    4. I agree that a cat shall reside strictly indoors, in my home. The dog/cat will live as a family member and companion only and not for any commercial, breeding, experimental or work purpose. Neither I nor my household members will expose the dog/cat to harmful objects, poisons, or other living creatures that may endanger it’s life.

    5. I will notify the City of College Park Animal Control Officer (“ACO”) immediately if the dog/cat is ever lost or stolen.

    6. I will allow the City of College Park ACO to check the dog/cat and its environment, including my home. If at any time the placement is found to be detrimental to the dog/cat’s health, or mental or physical well-being, the officer reserves the right to remove the dog/cat from said placement.

     7. I agree that the City of College Park does not warrant  the physical condition or temperament of the dog/cat and that I take the dog/cat as is, with all defects either observable or not observable. I assume full risk for such dog/cat from the date of signing of this Agreement.   While the City  endeavors to place only healthy animals, it cannot guarantee the condition of any animal and shall not be held responsible for any non-routine medical expenses which may be incurred, hereby expressly excluding any implied or express warranties of merchantability or fitness for any particular purpose, including, without limitation, any warranties regarding health, temperament or whether the animal is housebroken.

     8. RELEASE OF LIABILITY AND INDEMNITY: I promise and agree to be solely responsible for the dog/cat and to indemnify and hold harmless the City of College Park, its agents, representatives, officials, officers, and employees, from any and all claims of liability for any conduct, behavior, damage or injury caused by the dog/cat to any person or property on or after the date of this Agreement; and from any claim for damages known or unknown arising out of this Agreement.

     9. I understand and agree that any foster animal(s) remain the sole property of City of College Park , that I must abide by any decisions made regarding their care and treatment and that fostering does not grant me any sort of ownership over the foster animal(s).       

    10.I understand and agree that I must  return the foster animal(s) as instructed upon request or if I am   no longer able to adequately care for them.        

    I hereby certify that all information given on this form is true and correct to the best of my knowledge and information.                

     This form will be used as an Application and Agreement. If accepted after being reviewed by the City of College Park’s ACO, it will be signed by the officer, and returned to me as a copy of the Foster Program Agreement, which will apply when and if a foster animal is placed with me. I  will be contacted by the officer when foster opportunities arise. I may accept or not accept a foster animal when contacted. I must notify the ACO of any changes in my information. 

    To contact the ACO, call (240)- 375-3165 (cell) or (240)-487-3575 (desk)

51. First Name
52. Last Name
53. Date
    Date
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55. 1. Receive an email copy of this form.
56. Email address

    This field is not part of the form submission.

57. Submit

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