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CHAMPLIN PARKS AND RECREATION DEPARTMENT <br /> II- ADOPT-A-PARK PERMIT <br /> <br />The Champ~ini Parks and Recreation Department reserves the right to refuse, cancel <br />or reviee~t~s agreement if in its sole judgment the nature of the group or its <br />sign is ~li~cal, controversial or in questionable taste, or if the group is not <br />meetin~ ~[h.e ~er~s and conditions of this agreement. By signing this agreement, <br />the grouP im~owledges the nature of the work and agrees to comply with the terms <br />and c°ndl~lO, ns herewith to the satisfaction of the Champlin Parks and Recreation <br />Departmen~. ii <br />Except fQf ~he negligent acts of the City of Champlin, its agents and employees, <br />the volunteers or their agents shall assume all liability for, and save the City <br />of Ch~pl~n~'~ its agents and employees, harmless from, any and all claims for <br />damages, ~c~'.ions or causes of action arising out of the work to be done herein. <br />Any an~ ~1~ volunteers of the group or other persons while engaged in the <br />performa~e i~of any work or service performed under this agreement shall not be <br />considere~ ~e~ ployees of the City of Champlin, and any and all claims that may or <br />might ar£~e !~_n~er the Worker's Compensation Act of Minnesota on behalf of said <br />employees~,o~', other persons while so engaged, and any and all claims made by any <br />third p&~Y i~f the group's volunteers or other persons while so engaged on any <br />of the wo~ki!Or services to be rendered shall in no way be the obligation or <br />responsibil ~!~y of the City of Champlin. <br /> <br />of <br /> <br /> .~ (Please Print) <br />Name of ~rOu~Representative <br />Address <br /> <br />Phone(H) '~ (W) <br />Name to ApPear on Sign <br />Name of Par~Assigned <br /> <br />our Organl.'za.tion Would Like to Make a Two-Year Committment to the Adopt-A-Park <br />Program ~es No <br /> <br />Comment: <br /> <br />S~gn&ture of Group Representative <br /> <br />Date <br /> <br />872. bh <br /> <br /> <br />