When you adopted your Col. Potter Rescue Cairn, you would have received their Col. Potter foster tag on their collar. You can choose to continue to use this foster tag. However only very basic information and service is available with the foster tag. You only get a single contact with a phone number and email address; there are no emergency contacts, veterinary care information, medical information on file, away from home coverage, etc. If you wish to upgrade your foster tag and enroll in the TAG PROGRAM, fill out the following form. It is important that you provide us with as much information as possible. By doing so you make it easier for us to locate you should your pet be found. Information supplied to CPCRN will be NOT be used in any manner other than as it pertains to the Tag Program. Your information will only be given out on a "need to know" basis, in the event your dog has been lost or found. The TAG PROGRAM provides you with a one year membership in the tag registration service. After the year is up, your membership in the tag registration service IS AUTOMATICALLY RENEWED ANNUALLY BY CPCRN AT NO ADDITIONAL COST  TO YOU,  FOR THE LIFE OF YOUR PET. The tag is not transferable to another pet nor can it be transferred to a new owner should you rehome your pet with a new family. If at any time, it is discovered that another pet is wearing our individually registered tag or the pet now has a new owner, the tag will be deactivated and removed from our records. The Col. Potter Tag Program is not a pet finding service, so all other methods of trying to locate a lost pet such as advertising, flyers, etc., remain the pet owner's responsibility. Our tags are a notification service only, in the event your pet is found. * Required field Number of Tags*   Select Number of Tags to Upgrade 1 tag ($15) 2 tags ($30) 3 tags ($45) 4 tags ($60)   E-mail*   Payment Method*   Check   PayPal Personal Information Home Address* City State/Province Zip/Postal Code This must be your home address, Post Office boxes will not be accepted. You* First Name* Last Name* Home Phone* Work Phone Cell Phone Pager E-Mail #1 E-Mail #2 If you don't have voice mail or don't have access to it every day of the week, email may be the only way we have to leave you a message about your missing pet. For example, on the weekend, you wouldn't normally be monitoring your Work number or Work E-mail address. Also if you access the internet using dialup and this blocks your telephone, email could be the fastest way of contacting you. Partner/Spouse First Name Last Name Work Phone Cell Phone Pager E-Mail #1 E-Mail #2 If you don't have voice mail or don't have access to it every day of the week, email may be the only way we have to leave you a message about your missing pet. For example, on the weekend, you wouldn't normally be monitoring your Work number or Work E-mail address. Also if you access the internet using dialup and this blocks your telephone, email could be the fastest way of contacting you. Emergency Contacts You can specify up to five additional contacts to be used if we cannot reach you or your partner/spouse. First  Name Phone Relationship Lives within 30 minutes of me Second Name Phone Relationship Lives within 30 minutes of me Third Name Phone Relationship Lives within 30 minutes of me Fourth Name Phone Relationship Lives within 30 minutes of me Fifth Name Phone Relationship Lives within 30 minutes of me Veterinary Care Please answer the following questions regarding your intentions about emergency medical treatment and/or boarding, in the event you cannot be immediately reached by phone. Based on your reply, "need to know" information will be provided to the Finder, vet and/or boarding facility.  Please understand that there is NO guarantee that any facility will honor your request or that your agreement to be held financially responsible will be honored, and treatment given. Boarding Authorization * In the event that my pet is found, I authorize Col. Potter Cairn Rescue Network to notify the Finder that my pet can be taken to a vet or boarding facility; should they be unable to retain my pet in their care for any reason. With this authorization, I agree to be the financially responsible party for any boarding expenses that may be incurred, NOT Col. Potter Cairn Rescue Network NOR the Finder. I also understand that some facilities require inoculations upon intake when previous inoculations cannot be verified. If this is the case, I understand that I will be responsible for the inoculation charges as well. I also understand that giving this authorization does not guarantee that my pet will be boarded. It simply could provide the deciding factor as to whether or not the vet or boarding facility would accept my pet until I can get them. NOTE: Denying authorization may result in your pet being taken to a shelter or being released back out on the street. Authorize Deny Authorization Veterinary Care Authorization * In the event that my pet is found, and my pet has a medical condition or has been health compromised or injured in any way, I authorize Col. Potter Cairn Rescue Network to notify the Finder that my pet should be taken to a vet. With this authorization, I agree to be the financially responsible party for any treatment my pet receives at the health care center, NOT Col. Potter Cairn Rescue Network NOR the Finder.  I also understand that giving this authorization does not guarantee that my pet will be treated. It simply could provide the deciding factor as to whether or not the vet would accept my pet and give them the necessary medical care.  NOTE: Denying authorization may result in your pet not receiving necessary medical care. This could result in a facility refusing to take your pet into their practice and possibly your pet’s death. MOST facilities that receive injured animals where ownership is not known at the time will ONLY treat the animal to the extent of stopping pain, bleeding or discomfort, when brought in for initial treatment. SOME vets may not treat a pet at ALL without the owner’s consent. Authorize Deny Authorization If you wish to have your pet treated or boarded at your regular Veterinarian, please fill out the following section. NOTE: There is no guarantee that your pet will be taken to your vet, as circumstances may not make this possible. Name of Practice Name of Veterinarian Office Hours Phone Address City State/Province Zip/Postal Code Directions Provide some information on how to get to the Veterinarian. For example, crossroads where the office is located. Pet Information First* Adoptive Name* Foster Name* Foster Tag #* Type/Breed* Gender* Age* Select Gender Female Male Year(s) Month(s) Description* Medical Information List any medical conditions, medications, including dosage, diet and other important information Second Adoptive Name Foster Name Foster Tag # Type/Breed Gender Age Select Gender Female Male Year(s) Month(s) Description Medical Information List any medical conditions, medications, including dosage, diet and other important information Third Adoptive Name Foster Name Foster Tag # Type/Breed Gender Age Select Gender Female Male Year(s) Month(s) Description Medical Information List any medical conditions, medications, including dosage, diet and other important information Fourth Adoptive Name Foster Name Foster Tag # Type/Breed Gender Age Select Gender Female Male Year(s) Month(s) Description Medical Information List any medical conditions, medications, including dosage, diet and other important information NON-FINANCIAL RESPONSIBILITY CLAUSES PLEASE CLOSELY READ AND COMPREHEND THE FOLLOWING NON-FINANCIAL RESPONSIBILITY CLAUSES for Col. Potter Cairn Rescue Network AND/OR ANY second party who may find OR try to help your lost animal Rewards* I understand that my CPCRN tag has the word "REWARD" on the tag.  This reward can be a small financial reward or gift.  I understand that I, NOT Col. Potter Cairn Rescue Network, am responsible for providing any reward given in any form. CPCRN Financial Responsibility* I understand that Col. Potter Cairn Rescue Network NOR any of their volunteers WILL BE or ARE financially liable or responsible in ANY WAY should my dog be found and incur ANY medical OR OTHER expenses from treatment [known or unknown], such as medical treatment, boarding, food, etc. Unknown "Party" Financial Responsibility* I understand that ANY unknown "Party" who may find my dog shall NOT be held financially responsible in any manner, during their "Good Samaritan" attempt while helping my pet find their owner, EVEN if additional medical expenses, injury or even death occur when trying to move or help my pet.

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