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HomeMy WebLinkAboutAdopt A Park Application IOWA CITY PARKS AND RECREATION DEPARTMENT 220 S. Gilbert Street Iowa City, IA 52240 APPLICATION TO ADOPT-A-PARK NAME OF IOWA CITY PARK YOU WISH TO ADOPT: 1st choice______________________________________________________ 2nd choice______________________________________________________ 3rd choice______________________________________________________ NAME OF SPONSOR (organization, group or individual): _________________________________________________________________ Please type or print name as it should appear on Adopt-A-Park sign. SPONSOR'S MAILING ADDRESS: _________________________________________________________________ (Street, P.O. Box, City, State, Zip Code) PLEASE LIST TWO CONTACT PERSONS: NAME:_____________________________________________________________ PHONE: DAY_________________________ EVENING_____________________ NAME:_____________________________________________________________ 2 PHONE: DAY_________________________ EVENING_____________________ The Sponsor proposes to perform the following described work (as indicated with a check mark) within the above-named city park: REQUIRED Litter Removal at least twice a month, including raking through sand areas, if any, to find and remove hidden litter ___ Landscaping and Landscape Maintenance ___ Painting and/or Repair to Equipment* ___ Painting and/or Repair to Building(s)* ___ Plantings (weed removal, trimming grass, planting flowers, watering plant materials) ___ Installation of new equipment ___ Other (please describe below) _________________________________________________________ _________________________________________________________ * Includes reporting any items in need of repair, particularly if a safety concern is involved The Sponsor agrees that if approval is given to adopt the above- named park the following stipulations shall govern: 1. This application shall have been approved and signed prior to Sponsor beginning any operations as requested herein. 2. Sponsor agrees to indemnify and hold harmless the City of Iowa City, its officers, agents and employees from all liability, judgment costs, expenses and claims growing out of damages, or alleged damages of any nature whatsoever to any person or property arising from the performance or non- performance of the Sponsor's Adopt-A-Park Agreement, sponsorship, sponsorship activities or work. 3 3. For special projects (e.g. plantings, repair projects, installation of new equipment), the Sponsor agrees to contact the Superintendent of Parks and Forestry (356-5107) at least one week in advance to coordinate the project. A Proposed Work Plan form is provided which you may complete. 4. The Sponsor shall carry on the work as required and authorized by the agreement with serious regard to the safety of the traveling public, adjacent property owners and volunteers or employees of the Sponsor. The Sponsor agrees to instruct their volunteers in safety precautions. 5. The Sponsor acknowledges that all personnel involved in the project are initiators and volunteers directed by the Sponsor and that the Sponsor accepts full responsibility for any injuries or damages sustained by or caused by such personnel. The Sponsor acknowledges that they or their volunteers are in no way considered to be employees of the City of Iowa City, Iowa. In consideration of the above, the Sponsor and the Department further agree to the following terms and conditions of this agreement: Sponsor's Additional Responsibilities: 1. To perform the work specified in a safe and satisfactory manner. 2. To keep track of the number of volunteer hours performed, and submit this information to the Department on a monthly basis. 3. To provide adult supervision at the work site when volunteers include youth. 4. To obtain required supplies and materials as may be needed from the Parks and Forestry Division during regular business hours (7:00 a.m.-3:30 p.m., Monday-Friday). 5. To place filled trash bags used during collection of litter adjacent to existing park trash containers for pick up and disposal by the Department. 6. To return all unused materials and supplies furnished by the Parks and Forestry Division to the Department within one (1) week, unless other arrangements have been made. 7. To notify the Parks and Forestry Division at 356-5107 of items or grounds in need of attention or repair, especially when a safety concern exists. Department Responsibilities: 4 1. To erect a sign with the Sponsor name or acronym displayed. 2. To remove filled trash bags used for litter pick up by Sponsor, and to remove large, heavy or hazardous items when found in the park. 3. To provide report forms and envelopes to the Sponsor. 4. To supply certain materials and equipment when necessary (e.g., trash bags, paint supplies, flowers, mulch, etc. - NOTE: Sponsors are encouraged to provide their own tools when possible). 5. To follow up on necessary repairs as reported by the Sponsor. The Department reserves the right to terminate this agreement and remove the Adopt-A-Park sign when in the sole judgment of the Department, it is found that the Sponsor has not met the terms and conditions of this agreement. APPLICANT/SPONSOR:_______________________________________________ (Please print or type name) SIGNATURE: ______________________________________________________ (If an organization, an officer of the organization must sign) TITLE OF OFFICER (if any):_______________________________________ ADDRESS:_________________________________________________________ PHONE: DAY_______________________ EVENING_____________________ PARKS AND RECREATION DEPARTMENT APPROVAL 5 Recommended for Approval:________________________________________ Parks and Forestry Superintendent APPROVED:________________________________________________________ Director of Parks and Recreation DATE:_____________________ THIS AGREEMENT SHALL REMAIN IN FORCE FROM ____________________, _____ UNTIL __________________, _____.