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:_____________________________________________________________
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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.
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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:
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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
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Recommended for Approval:________________________________________
Parks and Forestry Superintendent
APPROVED:________________________________________________________
Director of Parks and Recreation
DATE:_____________________
THIS AGREEMENT SHALL REMAIN IN FORCE
FROM ____________________, _____ UNTIL __________________, _____.