First Name*

Last Name*

Phone*

Email*

Address*

Address Line 2

City*

State*

Postal Code

Section 2

What jobs would you like to help with?

Telephone Calling
Telephone CallingLetter Writing (Acknowledging Donations, etc.)Home VisitsTelephone CounselingFundraisingSocializing & Walking Kennel DogsVet VisitsFoster HomeTransportationHands on Problem SolvingTraining HelpOther, Please Specify
Other=

Section 3

Are you willing to help transport a foster dog?
YesNo

Section 4

Please read carefully
Our rescue experience has taught us that imposing some basic rules, and sharing tips for proper care will make the transportation and foster home experience safe and successful for the dogs rescued and for the humans and animals who share the same home. Before you volunteer, we ask that you review these rules and sign below indicating that you agree to abide by them.

Dogs will not be placed in dangerous situations (e.g. riding in an open pick-up truck).
Dogs will be kept in a secure area when not under supervision, preferably in a crate that will ensure its safety and the safety of your family, your animals and your property.
Dogs will be properly fed, given water, groomed, exercised and socialized.
Dogs will not be allowed off leash except in a secure fenced area of your property and you will not use chains or tie-outs as a substitute for exercise.
HEARTLAND GOLDEN RETRIEVER RESCUE will not be responsible for illness of or injuries to people or pets, or for loss of or damage to property resulting from the failure to follow these rules.
Dogs will remain the property of HEARTLAND GOLDEN RETRIEVER RESCUE until formally placed in an adoptive home.
HEARTLAND GOLDEN RETRIEVER RESCUE reserves the right to remove the dog from a foster home for any reason.
Dogs in foster care will always wear the ID on their collar. This can be a generic tag, with address and phone number of foster family, that can be easily removed from a collar and transferred to another dog coming into foster care.

I attest that I understand the important issues addressed in the above rules. By signing, I agree to adhere to the conditions and requirements of this agreement. I am signing of my own free will and not under duress of any kind. I affirm that I have never been charged with animal cruelty, and that I am not, nor have ever been an animal dealer or broker. I hereby authorize our veterinarian to disclose medical information to a representative of HEARTLAND GOLDEN RETRIEVER RESCUE

E-Signed (First and Last Name)

Date

Section 5

Please read carefully
The undersigned (hereafter referred to as “the volunteer”) has agreed to volunteer his/her services or facilities to HEARTLAND GOLDEN RETRIEVER RESCUE. The volunteer acknowledges and understands that the dogs involved in HEARTLAND GOLDEN RETRIEVER RESCUE RESCUE’S program may be untrained or unhealthy, and that HEARTLAND GOLDEN RETRIEVER RESCUE makes no representations whatsoever regarding the dog’s temperament, health (including the presence or absence of diseases transmissible to humans or other animals), age, ability, attitude or obedience skills. The volunteer assumes all risks relating to working with HEARTLAND GOLDEN RETRIEVER RESCUE dogs. The volunteer hereby releases HEARTLAND GOLDEN RETRIEVER RESCUE, its officers, directors, members, participants, volunteers, and affiliates HEARTLAND GOLDEN RETRIEVER RESCUE participants) from any and all claims, actions, liabilities, damages and costs of any kind (“claims and costs”) arising out of the transportation, fostering or any other work or activity with any dog connected with HEARTLAND GOLDEN RETRIEVER RESCUE. If anyone in the volunteer’s household, or any business or social visitor to the household, makes a claim, the volunteer will indemnify, defend and hold HEARTLAND GOLDEN RETRIEVER RESCUE and the HEARTLAND GOLDEN RETRIEVER RESCUE participants harmless from such claims and costs.

E-Signed (First and Last Name)

Date