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Pet Friendly Shelter Application

Please correct the field(s) marked in red below:

1

Care Taker at PFS Drivers license or ID# 

2
Owner's Name: 
3
Care Taker at Pet Friendly Shelter Name if Different:
4
Phone Numbers: 
Phone Numbers:
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Address: 
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What type of animal?
What type of animal?
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Sex:
Sex:
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Is your pet spayed/neutered?
Is your pet spayed/neutered?
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Description:
Description:
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Identification: 
Identification:
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Is your pet microchipped?
Is your pet microchipped?
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Veterinary Information: 
Veterinary Information:
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Pet Behavior:
Pet Behavior:
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Is your pet good around children?
Is your pet good around children?
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Is your pet good around dogs? 
Is your pet good around dogs?
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Is your pet good around cats?
Is your pet good around cats?
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Specify identifying marks and/or features that would help to ID your pet: 
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Has your animal been pre-classified or classified as dangerous? 
Has your animal been pre-classified or classified as dangerous?
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Does your animal have a bite history? 
Does your animal have a bite history?
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Upload a photo of your pet to help with identification: 

I understand that an emergency exists and that special arrangements have been made to allow my family and pets to remain together at this shelter facility.  I understand and agree to abide by the pet care rules contained in this agreement and have explained them to any other family member accompanying me and my pet.

 

1. My pet will remain contained in a carrier approved by the animal care personnel except at posted times designated by the shelter staff when I will be able to exercise my pet (if appropriate) and clean its carrier. Dogs will be on a leash any time they ate not in their crate/carrier. 

2. I agree to properly feed, water, medicate and generally care for my pet as instructed by the animal care & control staff.

3. I agree to properly sanitize the areas used by me pet, including performing proper waste disposal and disinfecting as instructed by animal care & control staff.             

4. I will maintain proper identification on my pet at all times to include the neck band issued upon entry.

5.  I will not permit any other shelter occupant to handle or approach my pet either wild in its carrier or during exercise time.  I will make sure the carrier door remains securely latched.                              

6. I understand that if my pet becomes unruly or aggressive or begins to show signs of stress related condition, or appears sick or has parasites etc., it may be removed to a more appropriate location at the discretion of animal care & control staff.

7. I understand that any decision concerning the care and welfare of my pet and the shelter populations as a whole are within the discretion of the animal care & control staff.

8. I agree that any shelter owned equipment used by my pet or myself must remain at the facility and maintained in good, clean condition while I utilize it.  All equipment must be left at the shelter upon the removal of the pet.

9. I agree that when it is announced the shelter is closing, I must remove my animal from the property.  Any animals not reclaimed and removed from the shelter will be related to the Clay County Animal Care & Control shelter located at  or other shelter and will remain there as a stray as required by County Ordinance and state statute.

10.  I agree that if at any time I fail to follow the rules as set forth, my pet and I will be asked to leave the facility.

 

I certify that my pet has not been diagnosed with any contagious diseases and is parasite free.

I hereby agree to hold harmless all persons, organizations, corporations or government agencies

Involved in the care and sheltering of my animal(s). I further agree to indemnify any persons or entities which may suffer any loss or damage as a result of my animal(s) or the care and sheltering they receive under this Agreement.

Please print out a copy of this completed document for your records and bring it to the shelter with you. You will be required to have a picture Identification with you at the time you are admitted to the shelter. Fax completed form to 904-284-7812.

For more information, please contact:  Animal Control at 904-269-6342. Fax 904-284-7812 or email us at: animalcontrol@claycountygov.com

Clay County is working to meet the needs of the community by creating a pet Friendly public Evacuation Shelter program. This program is in Development as a coordinated project between the various clay county departments such as Animal Control, the Emergency Operations Center, the clay county Health Department, the Clay County School System and the American Red Cross.

1. Animal species accepted into the shelters will be: 

Guide animals

Dogs 

Cats

Rodents (such as hamsters, gerbils, etc.)

Rabbits

Birds

NO REPTILES WILL BE ALLOWED IN THE SHELTERS

2. All pets must have proof of current vaccination and CCACC registration, be properly crated/caged and will be maintained by their owners. Animals may be housed in separate rooms than their owners. 

3. Owners should provide all necessary supplies to maintain their pet. 

4. We are asking the public to pre-register annually. People will have the option to pre-register online. 

5. For further information, please call (904) 269-6342. 

 

If this registration has been filled out electronically, you will be asked to sign a copy when you arrive at the shelter.

21
I agree to the above rules and conditions. 
I agree to the above rules and conditions.
22
Please sign electronically that you read and understand the agreement. 

If you would like to print your completed form for your records, please do so now before clicking Submit.

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