Polk County Humane Society
P.O. Box 334
Bolivar MO 65613
417 777-3647 (DOGS) 417 777-3647 (DOGS)
The parties hereto agree as follows: The Foster Caretaker ("the caretaker" or "you") signing below hereby acknowledges receipt from the Polk County Humane Society Animal Shelter or ("PCHS/we/us")of the animal(s) described below for foster care, custody, and possession of the animal(s), agrees to be bound by the covenants and conditions stated below.
FOSTER CARE PERSONAL INFORMATION
Address: _________________________ City: _________________ State: ____________ Zip: ______
Telephone Number: _______________________ Cell Phone Number: ___________________________
Name: _________________________________ Intake Number: ______________________________
Breed: _________________________ Sex: ___________________ Age: ________________________
Medication/Vaccinations Received: ________________________________________________________
The parties agree that:
1. THE FOSTER CARE. The caretaker shall provide the animal(s) with good care in their home, including, but not limited to food, water, shelter, outdoor exercise, socializing and playing, transportation to a veterinarian, grooming, training, transportation to events, bottle-feeding and medication when required. You are providing the Foster Care out of your love for animals and as a volunteer at no charge to Polk County Humane Society.
2. OWNERSHIP. As between the caretaker and the Polk County Humane Society, the animal(s) shall remain the sole property of Polk County Humane Society.
3. RETURNING FOSTERED ANIMAL(S). The animal(s) shall be returned to Polk County Humane Society upon request by either party, or if you are no longer able to care for the animal(s) or if you are relocating outside the Polk County, Missouri area.
4. INSPECTION. Agents of Polk County Humane Society will be allowed to conduct a home visit to the premises in which the animal(s) will be maintained or are maintained from time to time for the purpose of determining the suitability of those premises for the care and maintenance of the animal(s).
5. PLACEMENT OF ANIMAL(S). The caretaker understands and acknowledges that he/she does not have any right or authority to keep the foster animal(s) or to place the foster animal(s) in homes or place with other individuals unless permission is given by the Polk County Humane Society Shelter Manager.
6. COSTS AND EXPENSES. Polk County Humane Society will provide initial vaccinations and medication for minor existing ailments and will provide dog/cat food and litter to the caretaker for use by the fostered animal(s). Polk County Humane Society will pay all veterinary treatment costs that may be incurred for the animal(s) during the foster care; provided that Polk County Humane Society has given the caretaker approval for such treatments, except in the event of a medical emergency, in which case the caretaker will use their best judgment in the matter. The caretaker will give Polk County Humane Society receipts from the veterinarian for the veterinary care and medications. Veterinarians used by Polk County Humane Society are:
All veterinary care must be handled by one of these three veterinarians. The caretaker agrees that should the animal(s) require extensive medical treatment the Polk County Humane Society my request immediate return of the animal(s) and may euthanize the animal(s) for humane reasons.
7. ADOPTION BY CARETAKER. In the event that the caretaker wishes to adopt any or all of the animal(s) as a household pet for themselves, the caretaker must first enter into the Polk County Humane Society Adoption Agreement.
8. NO LIABILITY. The caretaker is not liable to Polk County Humane Society for any injuries, illness or disappearance of the animal(s) arising out of the foster care, except if such injuries, illness or disappearance are caused by or arise out of the caretaker's gross negligence or intentional misconduct. Polk County Humane Society is no liable for any bodily injury or property damage, losses or injuries whatsoever to the caretaker or other persons or to the caretaker's or other person's animals and pets, caused by the actions, behavior or health of the animal(s), or arising out of the foster care, except if such damage, losses or injuries are caused by the Polk County Humane Society's gross negligence or intentional misconduct.
9. RETURNING ANIMAL(S). The caretaker agrees to return said animal to the Polk County Humane Society not later than _________________(subject to change if authorized by Polk County Humane Society personnel).
This contract represents the entire agreement between the parties and any modifications will be made in writing and signed by both the caretaker and the Polk County Humane Society Shelter Manager or Board Member.
Signature: __________________________________ Date: _________________________________
Polk County Humane Society:
Signature: __________________________________ Date: __________________________________