Saint Bernard Rescue Foundation - Nebraska Chapter

Name *

E-Mail *

Address *

Phone *

Cell Phone

Please list the names, ages, and relationship of all family members in the household (list each member on a new line):

Family Members *

Which member(s) of your family will feed/care for the Saints? *

If rent, list the landlord's information.

Name

Address

Phone

If renting, be advised that you must provide written documentation to SBRF from your landlord confirming that you are authorized to house and maintain pets on the property(i.e., letter from landlord, pet addendum, or proof of pet deposits).

If you have a fenced yard, please provide details.

Fence Height

Fence Type

Fence Size (sq. ft.)

If your yard is not currently fenced, are you willing to install a fence or leash walk at all times? *

Yes No

Name, address and phone number of current or last veterinarian:

Name

Address

City

Phone

Do you feel it is acceptable to let a dog roam freely? *

Yes No

Have you obedience trained a dog? *

Yes No

Are you willing to housebreak a dog? *

Yes No

Do you realize that Saints shed profusely (especially during the summer months), often drool or slobber, and rescue Saints often have behavioral problems? *

Yes No

During the night, where would the Saint sleep? *

When you go away for a few days, who will care for the dog? *

Explain what training method and collars you prefer.

Methods *

Are you willing to foster a dog that:

Is 8 years of age or older? *

Yes No

Is not reliable with children? *

Yes No

On occasion, we receive pairs of Saints that have bonded and need to remain together, would you consider fostering such a pair? *

Yes No

Is physically handicapped? *

Yes No

Has been abused? *

Yes No

Requires ongoing medications? *

Yes No

IN CONSIDERATION OF THE OPPORTUNITY TO FOSTER RESCUE DOGS, I AGREE TO THE FOLLOWING TERMS AND CONDITIONS, INCLUDING TO BE BOUND BY THEM:

I ASSUME THE RISKS OF BEING BITTEN, SCRATCHED, KNOCKED DOWN, INJURED OR FRIGHTENED, BY DOGS OR PUPPIES, IN CONNECTION WITH MY FOSTER CARE WORK FOR SAINT BERNARD RESCUE FOUNDATION, INC. (HEREAFTER "FOUNDATION"). I AGREE THAT THE FOUNDATION IS NOT LIABLE TO ME OR OTHERS FOR ANY INJURIES, DAMAGES, LIABILITIES, LOSSES, JUDGEMENTS, COSTS OR EXPENSES WHATSOEVER, WHICH I OR OTHERS MIGHT SUFFER, OR SUSTAIN IN CONNECTION WITH THE PERFORMANCE OF MY FOSTER CARE ACTIVITIES FOR THE FOUNDATION, UNLESS THEY ARE THE RESULT OF THE FOUNDATION'S GROSS NEGLIGENCE OR INTENTIONAL MISCONDUCT. I WILL INDEMNIFY, DEFEND, AND HOLD HARMLESS THE FOUNDATION, ITS VOLUNTEERS, OFFICERS, DIRECTORS AND REPRESENTATIVES, FROM AND AGAINST ANY CLAIMS, LEGAL ACTIONS, INJURIES, DAMAGES, LOSSES, COSTS OR EXPENSES (INCLUDING ATTORNEY FEES) WHATSOEVER SUSTAINED BY ANY PROPERTY, ANIMAL OR PERSON IN CONNECTION WITH MY INTENTIONAL MISCONDUCT OR GROSSLY NEGLIGENT PERFORMANCE OF FOSTER CARE ACTIVITIES FOR THE FOUNDATION, OR MY BREACH OF THE FOUNDATION RULES, REGULATIONS, PROCEDURES, POLICIES, OR PROGRAMS.

ALL OF THE INFORMATION I HAVE PROVIDED IN THIS APPLICATION IS, TO THE BEST OF MY KNOWLEDGE, TRUE AND COMPLETE. I UNDERSTAND THAT FALSIFYING ANSWERS IN THIS APPLICATION OR AT ANY OTHER TIME DURING THE FOSTER PROCESS DISQUALIFIES ME FROM FOSTER CARE.

BY TYPING BELOW, YOU ARE SIGNING THIS DOCUMENT AND AGREEING TO THE TERMS LISTED ABOVE.

Signatures of foster person(s):

X *

X

Would you like to be added to our E-Mail Group?

Yes No

Double check all answers before submitting, you will not be able to go back to edit this page. You will receive a copy of this application via E-Mail with more details on what happens next. Thank you for your application.