Foster Care Acknowledgement of Rescue Dog

I/We, the undersigned foster individual(s) state that I/we have on record with the Rescue Program an executed General Foster Care Agreement.

I/We acknowledge receipt on the _________ day of ________________, 20____ of the following rescue Siberian Husky, which I/we agree to keep in accordance with the executed General Foster Care Agreement.

Description of Siberian Husky:

Rescue Dog Number: Registered Name 
(if available):
AKC Number 
(if available):
Tattoo Number: Call Name:
Sex: Age: Eye Color: Coat Color and Markings:
Date Spayed or Neutered: Dates of Vaccinations:

If the dog has been surrendered, released, of found without any background information, check here:_______

If the dog has been surrendered or released with information, fill in as known:

Housedog? Yard dog? Housebroken? Leash broken?
Good/not good with children: Good/not good with other animals:
Obedience trained through level: Identified Problems:
Special Needs:

Acknowledged and Signed this ___________day of _________________, 20______.

Signature(s) of Foster Individual(s) 


Witness Signature