Residence Application | Peppers Ranch

Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Phone*
Preferred communication*
- Email
- Phone Call
- Text
Are you currently single or married?*
- Single
- Married
How long have you been married?*
Please enter a number greater than or equal to 0.
What is your current housing situation?*
- Rent
- Own
What is your eduction and/or vocational background?*
Has your spouse ever been convicted of a felony?*
- Yes
- No
Names, ages, DOB, and status of each child currently living in your home.*
Name Age DOB Status

Statuses could be biological, adopted, or foster care

Spouse Information
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Phone*
Preferred communication*
- Email
- Phone Call
- Text
What is your eduction and/or vocational background?*
Has your spouse ever been convicted of a felony?*
- Yes
- No

Life Styles
What are some of your family hobbies or activities you enjoy participating in?*
Pets: furry friends are a part of the family, too! Please provide a list of the animals in your home.*
What church do you attend, and how long have you and your family been attending?*
Describe your involvement within your church.*
Have you previously volunteered for Peppers Ranch?*
- Yes
- No
Does your family currently volunteer? If so, where, how often and in what way?*
Do you currently donate regularly to entities making a difference in the lives of others?*
- Yes
- No
- Sometimes but not regularly

Fostering at Peppers Ranch
If adequate space and resources were not an issue, how many children would you want to care for in your home?*
Describe your commitment to the foster children who have lived with you, are living with you now, or will one day call your house their "home."*
Describe your philosophy in reunification of foster children with their biological family.*
If you could create the perfect community for foster children, what would that look like?*
How do you think you help the foster children in your care?*
If approved - what is the first available date you would be available to move to the Peppers Ranch Community.*

References*
Name Phone Email Organization & Title What is your relationship?

Please include at least 4 references
Applicant Resume*
Spouse Resume*
Applicant Credit Report*
Spouse Credit Report*
Any additional information you would like to supply would be welcomed. Thank you for your interest in being a part of the Peppers Ranch family.*

Media and Liability Release
RELEASE OF LIABILITY*
On behalf of myself and each member of my family and any other person who may come onto referenced property as my guest or invitee, I do hereby RELEASE FROM ALL LIABILITY, claims, demands, actions or causes of action, or litigation and further agree to defend, indemnify and hold harmless Peppers Ranch Inc and Peppers Ranch LLC (Owner) and his agents and employees from any costs, damages or liabilities in any way related to any event, circumstance or activity occurring at or related to Owner regardless of whether any of the foregoing occurred as a result of any negligence of misconducts of any of the foregoing persons. Owner reserves the right to revoke the rights granted herein at any time if Owner determines said property is not being used in a safe manner or for any other reason determined by Owner.
- I agree to liability waiver as mentioned above
- I disagree
Media Release*
I hereby grant Peppers Ranch its legal representatives, agents, successors or assigns, permission to use me or my likeness in photographs, movie films, videotapes and/or sound records, or any part thereof in any and all of its publications, including website entries, without payment or any other consideration. I understand and agree that these materials will become the property of Peppers Ranch and will not be returned. I hereby irrevocably authorize the Peppers Ranch to edit, alter, copy, exhibit, publish or distribute the photographs, movie films, videotapes and/or sound records, for purposes of publicizing the Peppers Ranch programs or for any other lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph. I hereby hold harmless and release and forever discharge the Peppers Ranch legal representatives, agents, successors or assigns, from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization. I am 18 years of age and am competent to contract in my own name. I have read this release before agreeing below and I fully understand the contents, meaning, and impact of this release.
- I agree to media waiver as mentioned above
- I disagree
Name
This field is for validation purposes and should be left unchanged.

Foster Family Residence Application

Foster Family Residence Application

Step 1 of 7 - Your Information

Spouse Information

Fostercare

Life Styles

Fostering at Peppers Ranch

Media and Liability Release

Name	Phone	Email	Organization & Title	What is your relationship?

Name	Age	DOB	Status