Snow Shoveling Referrals Request

Snow Shoveling Referrals Request
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I qualify for the snow shoveling referral program because:

I'm at least 60 years oldI have a disability which precludes me from shoveling snow
Upon request, the Arlington Heights Senior Center will provide referrals of teenagers who are willing to shovel snow for Arlington Heights residents, age 60 and over or Arlington Heights residents who have a disability. The resident will contact the teen and make all arrangements with the teen to have their snow shoveled. The teen snow shoveler and the resident work out all details as to: areas to be shoveled, time to be shoveled, cost of job and payment arrangements. The Village of Arlington Heights makes no guarantees about this program.

I agree that I will indemnify and hold the Village of Arlington Heights harmless of and from any and all claims that may be made by any person or organization for personal injury and property as a result of participation in this Snow Shoveling Referral Program.

I have read the above description of the snow shoveling referral plan and understand and agree to the terms. My signature below indicates this understanding and agreement and certifies that the information I have provided on this application is accurate.
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