GRAFFITI REMOVAL KITS REQUEST FORM 2023

Name*

I wish to obtain a complimentary Graffiti Kit

Business Name*

Business Address*

Email*

example@example.com

I understand that Graffiti Kits are for the exclusive use of the Uptown Saint John membership who have had an incident on their property. Use of the kits, as well as any results, are agreed to be at the property owner's discretion and risk. I acknowledge that Uptown Saint John Inc. is not responsible for any damages that may occur.

I understand that Uptown Saint John Inc. does not provide insurance to cover any damages to our property.

On behalf of the above mentioned business, I hereby waive, release and discharge any and all claim of damages for personal injury or property damage which my be sustained arising from the use of the Graffiti Kit provided by Uptown Saint John Inc. This waiver is intended to release Uptown Saint John Inc. and their officers, employees, and volunteers, from and against any and all liability arising out of or connected in any way with the services provided by Uptown Saint John Inc. It is further understood and agreed that this waiver, release, and assumption of risk is entered upon behalf of the above mentioned business.

I have had sufficient time to review and seek explanation of the provision contained above, have carefully read and understand them, and agree to be bound by them.

One Graffiti Kit per property owner is allowed - Uptown Saint John Inc has the right to refuse distribution of the Graffiti Kits. Kits are available while quantities last and must be picked up at the Uptown Saint John office at 17 Canterbury Street.

Company Representative Signature*

Date*

Date

In order to request this service, all BIA levies must be paid in full, acknowledge and confirm that all BIA levies have been paid in full by writing below; "Yes, all BIA levies have been paid in full as of the date of application"*