| Shelterluv

Are you able to ensure your foster will be at all adoption events/vet nights/and medical appointments? Yes No

If no, please explain:

Do you live within 15-minutes of Bloomington/Normal? Yes No

Required due to medical concerns in case animals need to be brought to us.

If you currently rent your home, does your landlord/rental agency allow pets? Yes No I own my home

What is your preferred method of communication? Phone Email Text

We will communicate mostly via email. We do post available fosters on our private facebook page.

Employment Employed Retired Other (Explain below)

If the above choice was "other", please explain:

Do you currently foster for another animal welfare organization? Yes No

Do you have any disabilities that need to be accommodated?

If yes, please explain:

Please list the type and number of each pet that is currently in your household:

Please also list any outdoor pets such as chickens, horses, etc.

Describe any experience you have working with animals:

Are you comfortable caring for an animal that has special needs? Yes No Yes, with guidance

Do you have any specific requirements regarding the kind of animal you will foster?

Example: male, female, weight requirement, age, etc.

Have you been convicted of a felony within the last 7 years? Yes No

Emergency contact:

First, Last, Phone

I have read and agree to the Waiver and Release of Liability:

Waiver and Relase of Liability: Waiver and Release of Liability, Indemnification and Hold Harmless Agreement This waiver and release of liability, indemnification and hold harmless agreement is between the Volunteer and Pet Central Helps, 360 Wylie Drive, Normal, IL 61761, McLean County, IL and its directors, officers, employees, agents, assigns, legal representatives and successors (hereinafter referred to as PCH). As a volunteer that is 18 years old or older, I hereby understand and agree to the following: I agree to WAIVE and RELEASE the PCH from all liability, manner of actions, causes of action, debts, contracts, claims and demands for or by reason of any illness, death, damage, loss or injury to person and property, which has been or may be sustained as a direct or indirect consequence of the Volunteer's volunteering at or for the PCH and notwithstanding that such damage, death, illness, loss or injury may have been caused partly by the negligence of the PCH. I agree to INDEMNIFY and HOLD HARMLESS the PCH for any costs or liabilities which they may incur as a result of my volunteering at or for the PCH. I hereby give the PCH the unrestricted right and permission to copyright and use, re-use, publish, and republish photographic pictures of me and my pet, or in which I may be included intact or in part, composite or distorted in character or form, without restriction as to changes or transformations, or reproduction hereof in color or otherwise, made through any and all media now or hereafter known for illustration, art, promotion, advertising, trade or any other purpose whatsoever. I acknowledge and agree that I have carefully read this Agreement, that I fully understand the same, and that I freely and voluntarily execute the same. I understand that I may seek independent advice prior to signing this Agreement. I understand that this Agreement is binding on me, my spouse, my executors, administrators, personal representatives and assigns and that this Agreement has important legal consequences. The terms of this Agreement are contractual and non mere recitals. This Agreement will be construed in accordance with and governed by the laws of the State of Illinois.

Please enter anything else you might want us to know about yourself:

*I have read and agree to the Terms and Conditions