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r . ,. <br />:. <br />CHAMPLIN PARKS AND RECREATION DEPARTMENT <br />ADOPT-A-PARK PERMIT <br />The Champlin Parks and Recreation Department reserves the right to refuse, cancel <br />or revise this agreement if fn its sole judgment the nature of the group or its <br />sign is political, controversial or in questionable taste, or if the group is not <br />meeting the terms and conditions of this agreement. By signing this agreement, <br />the group acknowledges the nature of the work and agrees to comply with the terms <br />and conditions herewith to the satisfaction of the Champlin Parks .and Recreation <br />Department. <br />Except for the 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 Citg <br />of Champlin, its agents and employees, harmless from, any and all claims for <br />damages, actions or causes of action arising out of the work to De done herein. <br />Any and all volunteers of the group or other persons while engaged in the <br />performance of any work or service performed under this agreement shall not be <br />considered employees of the City of Champlin, and any and all claims that may or <br />might arise under the Worker's Compensation Act of Minnesota on behalf of said <br />employees or other persons while so engaged, and any and all claims made by any <br />third party of the group's volunteers or other persons while so engaged on any <br />of the work or services to be rendered shall in no way be the obligation or <br />responsibility .of the City of Champlin. <br />Name of Group <br />(Please Print). <br />Name of Group Representative <br />Address <br />Phone(H) <br />Name to Appear on Sign <br />Name of Park Assigned <br />(W) <br />Signature of Group Representative Date <br /> <br />