Canine Companions Rescue Center

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Volunteer Application

If you have any problems completing this form please go the the Documents link where you can print the application. If you have any questions please email us or call us at (248) 834-9419.

Date
Name
Street Address
City
State
Zip
Home Phone
Cell Phone
Birth Date
Drivers License Number
Expiration Date
Employer
Occupation
Work Phone
Can we call you at work?	yes no Not answered
E-mail Address
In case of emergency, please notify
Relationship
Phone
Cell Phone
Check any of the following you are interested in:	Temperament Testing Press release/Write articles Dog adoption shows Grants/Fundraising Training /Working with dogs Fostering Education Community Projects Other
If you checked "Other", please describe
Do you have any professional experience with animal-related fields (vet technician, trainer, groomer, etc.)?
Have you done volunteer work in the past (please describe when, where, and why you left)?
Do you have any special skills that you think may be helpful?
How do you feel about euthanasia?
Waiver of Liability and Agreement to Indemnify The Undersigned acknowledges that he/she desires to perform certain services (collectively, the “Services”) for CCRC, a Michigan non-profit corporation (“CCRC”). The Undersigned further understands and acknowledges that certain risks may be associated with performing the Services. In consideration of being permitted to perform the Services for CCRC, the Undersigned, for himself/herself and his/her heirs and representatives voluntarily and knowingly executes this document and expressly waives any and all rights, claims, or causes of action including, without limitation, those involving bodily injury or property damage to the Undersigned, or the the Undersigned’s family or property while the Undersigned is engaged, directly or indirectly, in performing the Services, whether or not caused by the negligence of CCRC, its officers, directors, agents or employees. In further consideration of being permitted to perform the Services for CCRC, the Undersigned hereby agrees to indemnify, defend and hold CCRC, its officers, directors, agents and employees harmless from and against any and all liability, damage, loss, cost and expense incurred as a result of any claim, demand, or cause of action, brought against CCRC, its officers, directors, agents or employees, jointly or individually, for bodily injury or property damage suffered as a result of the Undersigned/s negligent, reckless or willful act or omission in the performance (or failure to perform) of the Services. The Undersigned has read and fully understands the contents of this Waiver of Liability and Agreement to Indemnify. The Waiver of Liability and Agreement to Indemnify shall continue in full force and effect until terminated in writing and in the event of such termination shall remain applicable to all matters occurring or first arising on or before the date of such termination, regardless of such termination.
Please Type Name (this will serve as your signature)
Please complete the following only if you are interested in fostering a rescue dog:
Do you..	Own Rent Live With Parents Not answered
If you rent, name of landlord
Landlord's Phone
Do you live in a/an	Apartment House Condo Townhouse Trailer Park Not answered
Are there any pet restrictions where you live?	yes no Not answered
If yes, what are they?
Do you have a completely fenced yard?	yes no Not answered
If not, how will you contain the foster dog to your property (be specific)?
How many adults reside in your home?
How many children reside in your home?
What are the ages of the children?
How many hours per day would the dog be left alone?
When the dog is not supervised it will be	Loose in House Crated in House Room in House Yard Garage Not answered
Please list animals you own	Breed/Type Age M F Spayed/Neutered? Up to date on shots? Y N
	Breed/Type Age M F Spayed/Neutered? Up to date on shots? Y N
	Breed/Type Age M F Spayed/Neutered? Up to date on shots? Y N
	Breed/Type Age M F Spayed/Neutered? Up to date on shots? Y N
	Breed/Type Age M F Spayed/Neutered? Up to date on shots? Y N
Name of Veterinarian
City
Foster Agreement As a foster care provider, I agree to follow the Canine Companions Rescue Center (“CCRC”) guidelines in this agreement and all rules of the organization. I will provide each rescued dog with comfortable, clean housing, food and fresh water available at all times. I agree to keep any rescued dog in a secure, fenced environment or on a leash at all times. Veterinary care such as, but not limited to, vaccinations, heartworm tests, heartworm preventative, fecal tests, and spay/neuters will be provided by a CCRC approved vet. All such expenses (including emergency situations) must be approved in advance by CCRC. As a foster, I may need to transport the dog to the vet for these services. I agree to make the dog available for appointments and transport the dog to shows so they can be seen. HW pills will need to be picked up at the kennel monthly. I will contact CCRC immediately if there is any change in the dog’s health, personality or eating habits. I will notify CCRC immediately if a dog is lost or stolen and make all reasonable efforts to locate the dog. I agree to all the above terms and conditions and understand that CCRC will retain ownership of any dog I foster for them until it is adopted. If I choose to adopt a dog from CCRC I will pay the full adoption fee and fill out all standard adoption forms. Upon terminating my foster agreement with CCRC I agree to return all items I have borrowed. This contract may be terminated by the foster or CCRC at any time without reason.
Please Type Name (this will serve as your signature)