Adopt a Spot Agreement

Keep Midland Beautiful's Litter Control Program
City of Midland, Texas

Name of Organization as you wish it to appear on sign
Address of Organization Address of Organization
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Name (Team Leader) Name (Team Leader) First Last
Title
Phone Phone - ### - ### ####
Email
Adopt a Spot Location?
Date Date / MM / DD YYYY

Please complete the following
Please complete the following	Agree
WHEREAS, we recognize the need and the desirability of a litter free city.	WHEREAS, we recognize the need and the desirability of a litter free city.Agree
WHEREAS, Keep Midland Beautiful Litter Control Program has been established for civic groups and organizations to contribute toward the efforts of maintaining litter free city streets and public thoroughfares.	WHEREAS, Keep Midland Beautiful Litter Control Program has been established for civic groups and organizations to contribute toward the efforts of maintaining litter free city streets and public thoroughfares.Agree
WHEREAS, we are aware of the hazardous nature of the work which is performed	WHEREAS, we are aware of the hazardous nature of the work which is performedAgree
We accept the responsibility of picking up litter in this area a minimum of 2 times per year, report cleanup numbers each time, and promote a litter-free environment in the community.	We accept the responsibility of picking up litter in this area a minimum of 2 times per year, report cleanup numbers each time, and promote a litter-free environment in the community.Agree
We understand that this is an ongoing agreement and our group must clean up a minimum of 2 times per year and report those numbers to KMB each time.	We understand that this is an ongoing agreement and our group must clean up a minimum of 2 times per year and report those numbers to KMB each time.Agree
We understand if we are unable to keep our adoption commitment, the spot will become available for another group to adopt.	We understand if we are unable to keep our adoption commitment, the spot will become available for another group to adopt.Agree
We understand we are required to report all cleanups by completing the online form at keepmidlandbeautiful.org (prorgrams tab) or email kmb@keepmidlandbeauiful.org	We understand we are required to report all cleanups by completing the online form at keepmidlandbeautiful.org (prorgrams tab) or email kmb@keepmidlandbeauiful.orgAgree

In consideration of Keep Midland Beautiful’s acceptance of this entry in the above Project, we, the undersigned, individually and on behalf of our minor child/children, administrators and assigns, forever release and discharge any and all rights, demands, claims and causes of suite or action, known or unknown, whether arising now or in the future that we, individually and our minor child/children may have against Keep Midland Beautiful, its officers, agents, employees, and volunteers, and all other property owners and any other participating sponsors, as the officers, employees and agents of such parties for any and all injuries, including death and property damage, in any manner arising or resulting from participation in said Project. We attest and verify that we have full knowledge of the risks involved in the Project, that we individually assume those risks on behalf of ourselves and our minor children, and that we will individually without limitations, assume and pay any medical and/or emergency expenses in the event of an accident, injury, illness or other incapacity, regardless of whether we have authorized such expenses. Further, we state that we have carefully read this Release, know the contents of the Release, and sign this Release of our own free will.

In consideration of Keep Midland Beautiful’s acceptance of this entry in the above Project, we, the undersigned, individually and on behalf of our minor child/children, administrators and assigns, forever release and discharge any and all rights, demands, claims and causes of suite or action, known or unknown, whether arising now or in the future that we, individually and our minor child/children may have against Keep Midland Beautiful, its officers, agents, employees, and volunteers, and all other property owners and any other participating sponsors, as the officers, employees and agents of such parties for any and all injuries, including death and property damage, in any manner arising or resulting from participation in said Project. We attest and verify that we have full knowledge of the risks involved in the Project, that we individually assume those risks on behalf of ourselves and our minor children, and that we will individually without limitations, assume and pay any medical and/or emergency expenses in the event of an accident, injury, illness or other incapacity, regardless of whether we have authorized such expenses. Further, we state that we have carefully read this Release, know the contents of the Release, and sign this Release of our own free will. I have read and understand the terms the liabiltiy statement
I hereby grant the Keep Midland Beautiful, Public and Media Relations Office, the right to photograph members, employees, officers, and/or any agents participating in Keep Midland Beautiful events and to use or authorize the use of the photo for promotional purposes as related to Keep Midland Beautiful produced publications and materials and external publications and materials where Keep Midland Beautiful would release use of the photo to support information about Keep Midland Beautiful programs and services.
I hereby acknowledge that no fee is payable by Keep Midland Beautiful, Public and Media Relations Office, for this appearance or resulting distribution, and that the provisions of this release are legally binding.

I hereby grant the Keep Midland Beautiful, Public and Media Relations Office, the right to photograph members, employees, officers, and/or any agents participating in Keep Midland Beautiful events and to use or authorize the use of the photo for promotional purposes as related to Keep Midland Beautiful produced publications and materials and external publications and materials where Keep Midland Beautiful would release use of the photo to support information about Keep Midland Beautiful programs and services.
I hereby acknowledge that no fee is payable by Keep Midland Beautiful, Public and Media Relations Office, for this appearance or resulting distribution, and that the provisions of this release are legally binding. I agree I do not agree
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