Required fields are marked with asterisks (*)

Adopt-a-Spot Registration

In order to enhance the environment and the appearance of our community, the undersigned adopting group requests permission to Adopt-A-Spot at the following location.

Public Works Department
14199 Jasper Street NW | Ramsey, MN 55303
763-427-8254

Address or Boundary Description

Said work will be performed under and in accordance with the City of Ramsey terms attached hereto and incorporated herein by reference.

Adopting Groups with whom agreements are signed shall at all times indemnify and save harmless the City of Ramsey, and all employees, agents, and officers of the City, from responsibility, damage, or liability arising from the exercise of privileges granted under this agreement.

The City of Ramsey may terminate this agreement at any time the adopting group does not comply with this agreement or at anytime the adopting groups work effort is considered unsafe. The City of Ramsey reserves the right to revise or discontinue this program at anytime.

First Name:

Last Name:

Email:

Home or Cell Phone Number:

Address:

Address 2:

City:

State:

ZIP

Name(s) / Group Name to be put on the sign:

Adopt-A-Spot Agreement

The undersigned, Parks and Assistant Public Works Director or his official designee, has the legal authority to hereby give permission for the adopting group identified above to be involved with and designated in the Adopt-A-Spot Program.

Parks and Assistant Public Works Superintendent Signature

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Date

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