form center

2. Due to the large number of kittens we are currently caring for, out-of-county appointments are temporarily suspended.
4. First Name*
5. Last Name*
7. Cell Number*
8. Email Address*
10. Permission to Send Text Messages

    1. By checking this box you give WCAC staff permission to send messages to your cell number.
12. Home Address*
14. City*
15. State*
16. Zip Code*
18. Address where the kittens were found (if different from your home address)
20. City
21. State
22. Zip Code
24. Are you the caregiver of these kittens or group of cats?*
    -- Select One --Yes, I feed and/or otherwise care for cats at this locationNo, I got these kittens from someone I knowNo, I see cats here, but do not provide care for them personallyother
26. How many kittens are there? *
27. How old are the kittens?*
    -- Select One --Under 4 weeks of ageBetween 4 and 8 weeks of ageBetween 8 and 16 weeks of ageI am not sure. I need help estimating their ages.
29. List the name, gender, color, and estimated age of each kitten.*
31. Do you have access to the mother cat?*

    1. Yes, I have already had her spayed
    2. Yes and I intend to trap her for sterilization
    3. Yes, but I do not plan to have her sterilized
    4. No, she is deceased
    5. No, I do not know where she is
    6. Yes, she is caring for the kittens
    7. Other
33. Where are they living?
    -- Select One --Outside the homeInside (contained inside only)In a sheltered space with access to the outdoors.
35. Besides the mother cat, are there other unaltered cats at the location where the kittens were found?*
    -- Select One --Yes, and I intend to or have already trapped them for sterilizationYes, but I do not plan to have them sterilizedNo, there aren't any other unaltered cats at this locationOther
37. What do you plan to do with the kittens after they are sterilized?*
    -- Select One --I plan to keep them myselfI plan to adopt them out to friends and family, or utilize rehoming resources to find them homesI plan to adopt them out through a rescue that I operateI plan to give them to a rescue or shelterother
39. Are any of the kittens showing any symptoms of illness?*

    1. No, they appear healthy
    2. Eye discharge (clear, yellow or green) squinting, or swelling abnormal appearance
    3. Nasal discharge (clear, yellow, green or red) frequent sneezing
    4. Loose stool or diarrhea
    5. Other (please describe further in the next section)

    Check all that apply
41. Would like for the kittens to receive an ear tip?*

    1. Yes
    2. Maybe, I need more information
    3. No
43. Is there any thing else you would like us to know?
45. 1. I understand that through the kitten rescue + rehome program my cat(s) will receive spay or neuter, and *rabies shot (if 12 wks or older), FVRCP, 3-month flea control, and microchip, if I am unable to provide proof..*
    Initial
47. 2. I understand that the spay / neuter surgery carries a risk of complications, including death, to the animal(s). I hearby assume full responsibility and agree to waive any and all claims against Williamson County Government and Williamson County Animal Center ("WCAC") and their agents, officers, veterinarians, contractors, volunteers and employees in the event of escape, sickness, injury, complications or death of my animal(s) related to the spay / neuter surgery.*
    Initial
49. 3. I understand that animals may be groggy when released, and should be kept in an enclosed area for 24 hours after the procedure. I will make every attempt to observe the cat for post-surgical complications including, but not limited to, incision infection and lack of appetite. In case of post-surgical problems, I agree to arrange the appropriate veterinary care at a full service facility at my own expense.*

    Initial

51. 4. I agree to retrieve my cat(s) between 4pm + 5pm the same day as surgery. Cat(s) not picked up the day of surgery may be considered abandoned and subject to citation.*
    Initial
53. 5. To the fullest extent permissible under applicable law, I agree to hold harmless, indemify, and release Williamson County Government, and WCAC, their agents, officers, veterinarians, contractors, volunteers, and employees, from any and all loss, injury, liability, damage, or cost I may incur or suffer due directly or indirectly from the spay / neuter surgery and removal and housing of this animal whether caused by Williamson County Government or WCAC, their officers, agents, veterinarians, volunteers or employees. *
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55. 6. I VOLUNTARILY SIGN THIS RELEASE AND WAIVER OF LIABILITY, and further agree that no oral representations, statements or inducements, apart from this written agreement have been made. I further attest that the below listed cat is my pet or in my custody of care, and that I have the authority as the owner or agenty to authorize the removal and housing by WCAC.*
    Initial
57. I HAVE READ AND UNDERSTAND THE ABOVE RELEASE AND WAIVER OF LIABILITY AND INDEMNITY AGREEMENT AND I AGREE TO BE LEGALLY BOUND BY ALL TERMS AS PERMITTED BY APPLICABLE LAW.*
    Signature of Owner of Agent
58. Date*

60. *Please be sure to check your spam/junk folder if you do not receive a response to your application within 2-3 business days.*

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62. 1. Receive an email copy of this form.
63. Email address

    This field is not part of the form submission.

64. Submit

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