Fernie Pets Society
Spay Neuter incentive Program
(SNiP) - Application Form
First Name
Last Name
Street Address
PO Box
City
Postal Code
Home Phone
Cell Phone
Email Address
Approximate
annual household
income
Relationship
to cats/kittens
How many female
cats to be spayed?
$0 to $19,999
$40,000 to $49,999
$20,000 to $29,999
$50,000 to $59,999
$30,000 to $39,999
$60,000 and above
Owner
Homeless
Fostering
Feral
How many male cats to be
neutered?
.
.
Cat #1
Name
Gender
Color
Male
Female
Age
Hair Length
Marking / Description
.
Cat #2
Name
Gender
Color
Male
Female
Age
Hair Length
Marking / Description
.
Cat #3
Name
Gender
Color
Male
Female
Age
Hair Length
Marking / Description
.
Cat #4
Name
Gender
Color
Male
Female
Age
Hair Length
Marking / Description
.
Cat #5
Name
Gender
Color
Male
Female
Age
Hair Length
Marking / Description
.
SURGERY AGREEMENT AND WAIVER
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I, being responsible for the cat(s) described above, have the authority to grant the veterinarian, the SNiP
Program and their representatives, my consent to receive, treat and/or operate on these cat(s).
I understand that while all procedures are to be done to the best abilities of the staff, no assurance or
guarantee has been made of the results of any surgery or treatment, and that risks and probabilities of
complications exist in any surgical or medical treatment. I consent to the administration of anesthetics
and/or other medications as may be deemed necessary by the veterinarian.
I understand that as the owner, I am responsible for following the veterinary clinic's pre and post surgery
instructions exactly as required.
I will not hold the organizations that make up the SNiP Program and the SNiP volunteers, nor the
attending veterinarians and their staff responsible should my cat contract any disease whatsoever.
I AM AT LEAST 18 YEARS OF AGE AND AFTER CAREFULLY READING THE ABOVE,
I HAVE SIGNED IN AGREEMENT.
NAME
DATE
Print this form and drop it off at BARKSiDE Pets
or save and email it to [email protected]
Important Information - Please read
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The voucher for the veterinary clinic is valid for 60 days after issue. If you are unable to have your cat(s)
spayed or neutered within the 60-day period, you may request an extension from the SNiP Administrator.
If you are applying to have multiple cats spayed or neutered; in order to prevent unwanted pregnancies,
we recommend you have the females spayed first.
Before surgery, kittens must be a minimum of 10 to 12 weeks of age, healthy and 2 lbs in weight.
As the owner you are responsible for calling and booking the appointment at the clinic.
Veterinary clinics require a 24 hour cancellation notice or your voucher will be invalidated and not reissued.
As the owner you are responsible for the cat's transportation to and from the clinic, unless other
arrangements have been made with the SNiP Administrator.
You can contact the SNiP Administrator at [email protected]