Surrender Form

All items with an asterisk (*) are mandatory

We ask that you consider and answer each question carefully as the information you provide assists us in assessing your suitability as a foster and the type of dog we can place in your home.

Contact Information:

The following statements must be read very carefully and agreed to; they are non-negotiable. By placing my initials after certain statements and my name and date at the bottom of the form:

 

I give permission for a ACDR representative to call my listed references and do a home visit. It is understood that any information received will be held confidential.

 

I understand that the Atlantic Canadian Dachshund Rescue will be responsible for any medical, training or other approved expenses associated with the foster dog in my care. Note: If injuries or medical treatment is required as a result of negligence on the part of the foster home; the foster home will be held responsible for covering the costs of treatment.

I also understand that by signing this form I agree to release and covenant to hold harmless ACDR and its members from any claims, damages, costs, or actions incurred as a result of the foster care or actions of the foster dog.

 

I will notify ACDR immediately should the foster dog become lost, stolen, ill or die.

 

I agree to contact my ACDR Representative at least once per week to update her/him on the condition and well-being of the foster dog.

 

ACDR strongly discourages training or behaviour modification through physical violence of any sort. We will not condone nor tolerate hitting, ‘spanking’ or any other form of physical punishment.

 

All foster dogs must wear an I.D. collar with the foster’s home telephone number and the telephone number of your ACDR Representative at all times. This ID tag must be on the dog at all times and if the foster home does not have one, the foster must contact the ACDR to request one.

 

The foster home agrees to provide high quality food for the foster dog at their own expense. Treats, toys, beds etc. are also the responsibility of the foster home. The Rescue will try to help with these incidentals wherever possible.

 

ACDR reserves the right to perform unscheduled visits to the foster home at any time.

ACDR reserves the right to take the dog off the premises at any time. Note: If ACDR judges the foster dog to be in danger, this signed document releases ACDR to remove the dog from said premises without warning

The Foster/Representative understands that if accepting a dog into rescue as an agent of ACDR, that dog becomes the legal property of ACDR regardless. Any pulling, approved vetting fees, or adoption fees paid for out of pocket have been done so as an agent of ACDR and does not entitle the Foster/Representative to ownership of said animal. These expenses will be reimbursed by ACDR upon receipt of said dog.

The Foster/Representative understands that if they wish to adopt any ACDR dog, proper adoption procedure must be followed and if there is a waiting list for said dog, they will be put on the waiting list like all applicants. Special circumstances will be considered by the ACDR Board of Directors.


The foster home understands that ACDR cannot predict the behaviour of any dog in any situation. ACDR will provide any relevant information on the dog’s history and temperament that is known. This information may or may not be a reliable indicator of how the dog will behave in a new environment, including your home.


By typing my initials and my name as signature, I certify that I am at least 21 years of age and that I will be solely responsible for the care and well-being of any dog that I foster for ACDR. Any misrepresentation of the true facts in this application will invalidate the foster home agreement and will give ACDR the right to immediately reclaim the foster dog.

Signature:

Date:

© 2019 by Atlantic Canadian Dachshund Rescue 

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