Please cmplete this form if you are interested in volunteering to be a pet sitter in our Pet Sitting Program.  It is a wonderful way to volunteer and raise funds for your favorite Dog Rescue Organization. 

* Required fields
Name *
E-mail Address *
Street Address *
City, State, Zipcode *
Day Phone *
Evening Phone *
Best Time to Contact *
Please describe your residence *	HouseTownhouseApartmentCondo
Do you own your residence? *	YesNo
Do you have stairs in your home? *	YesNo
If yes, please describe
Do you have a fenced in yard? *	YesNo
If yes, how high and of what type of construction?
Please list All PEOPLE who LIVE in your household, age , relationship and work schedule *
Do kids under 6 visit your home? *	YesNo
If yes, who and how often?
Is anyone home during the day? *	YesNo
If yes, who and when? If no, how long will dog be left alone all day? *
Please list ALL PETS who LIVE in your household. Name, Type, Breed, Age , Gender, Spayed or Neutered *
How often do you feed your dog? *
Do you give treats to your dog? *	YesNo
Do you give rawhides to your dog? *	YesNo
Do you give pigs ears to your dog? *	YesNo
Maximum number of DOGS you can dog-sit for at one time *
Maximum number of DAYS you can dog-sit at one time (1-14 days) *
Do you own a crate? *	YesNo
Do you own any baby gates? *	YesNo
Please describe what kind of and how much exercise you are willing to provide a visiting dog *
Will you dog-sit for a dog with Behavioral Issues-discuss with Coordinator *	YesNo
Will you dog-sit for a dog with Medical Issues-discuss with Coordinator *	YesNo
Insurance Carrier *
Limits of Insurance *
Exclusion of Breeds *
Signature /S/ *
Signature of Spouse /S/
I have read and agree to the Privacy Policy *

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By agreeing to dog sit for GRRSN, the undersigned will follow all relevant procedures and guidelines in the GRRSN Foster Agreement, and will make no decisions or actions regarding the dog's veterinary care  (including euthanasia) without contacting the Foster Coordinator.  Except in life-threatening situations when GRRSN cannot be reached, veterinary care must be authorized by the Dog Sitting Coordinator.  Otherwise, the undersigned may be responsible for veterinary costs incurred.

The  undersigned shall provide the dog with a fenced-in yard or other humane means of exercise.  The animal shall not be kept constantly chained outside or tied inside.  The dog will never be allowed outside a secure fenced are unless on a leash.  The dog must be in the care of the GRRSN designated dog sitter at all times unless GRRSN authorizes other arrangements.  Dogs may not be left in the care of persons not designated by GRRSN as a dog sitter without the permission of GRRSN.  The undersigned shall treat the dog as a household pet and a member of the family and shall never use it for breeding.  The undersigned agrees to provide the dog entrusted to its care with adequate food, water, shelter, affection, socialization, exercise and medical care.  In addition, the undersinged agrees to return the dog to GRRSN upon demand.

The undersigned has agreed to volunteer service or facilities to GRRSN.  The undersigned acknowledge(s) and understand(s) that the dog(s) may be untrained or require medical care and that GRRSN makes no representations whatsoever regarding the dog's temperament, health (including the presence or absence of diseases transmittable to humans or other animals), age ,ability, attitude or trainability.

By signing this agreement, you assume all risk related to dog sitting for GRRSN.  The undersigned with the intention of binding the person completing this form and spouse and heirs, legal representatives and assigns, hereby releases GRRSN, its Board of Directors, members, officers and agents, volunteers and affiliates and/or any rescue representative charged or chargeable with responsibility or liability from any and  all  claims, actions, liabilities, damages, costs, expenses, loss of service, actions/causes of action that Member ever had, or now has or may have known or unknown, or that anyone claiming through or under the person completing form may have or claim to have againt GRRSN, its officers, directors, participants, members, volunteers, and affiliates arising out of any work or activity with any dog connected with GRRSN or a dog owned by a GRRSN member.  If anyone in the undersigned's household, or any business or social visitor to the household makes a claim, the Member will indemnify, defend, and hold GRRSN and its Board of Directors, members, officers and agents, volunteers and affiliates harmless from such claims and costs.   

Should you have any questions, please contact the Dog Sitting Coordinator:

Jessica

GRRSN Dog Sitting Coordinator

7065 W. Ann Rd. Ste. 130-656

Las Vegas, Nevada 89130

Telephone:480-307-1570

Fax:702-920-8768

Email jessicaharner@gmail.com