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CITY OF JEROME ANIMAL SHELTER- TRANSPORT APPLICATION Name: Date: Address: City/Zip: Phone number: Emergency contact: Phone: Vehicle Information: Vehicle Vehicle Model: What types of Transports are you willing to do? Mark all that apply o Single leg transports (1 to 2 hours) o Multi leg transports (1-2 hours to 4 hours) multiple people involved o Transports with single dog o Transports with multiple dogs o Transports with crates o Transports without crates o Transports with calm dogs o Transports with known behavioral issues Have you transported for any organizations before? o Yes o No Please give a brief background on your experience: What days are you available for transport? Mark all that apply Monday o AM o PM Tuesday o AM o PM Wednesday o AM o PM Thursday o AM o PM Friday o AM o PM Saturday o AM o PM Sunday o AM o PM Are you willing to accept the responsibilities of a transporter, to show up on time, properly communicate progress during the transport and transport any paperwork with care? o Yes o No ---PAGE BREAK--- CITY OF JEROME ANIMAL SHELTER- TRANSPORT APPLICATION AGREEMENT 1. The transporter is responsible for the care of the dog(s) during their portion of the transport. 2. The transporter understands that dogs being transported may experience car sickness and anxiety resulting in vomiting, chewing and diarrhea. 3. The transporter will not hold the City of Jerome or the City of Jerome Animal Shelter responsible for any damages that may occur during their transport that are caused by the dog(s) or other vehicle related incidents . 4. The transporter understands that the City of Jerome Animal Shelter will provide crates for each dog but if the transporter does not use them, the transporter is liable to any and all damages to the vehicle or dog in case of an accident. 5. The transporter understands that some dogs being transported may have behavioral issues such as jumping, biting, leash lunging etc. and they will not hold the City of Jerome or the City of Jerome Animal Shelter liable for any and all injuries that may occur. Signature of Applicant: Date: Signature of Shelter Staff: Date: SIGN SIGN