APPLICATION/AGREEMENT

ADOPTER INFORMATION

Organization or Group Name:

Primary Contact:*

Mailing Address:*

Daytime Telephone #:*

Email Address:*

example@example.com

PARK ADOPTION REQUEST

NOTE: Large parks may have two or more adopters. Specific park areas and activities can be pre-arranged with Memphis City Beautiful. All efforts will be taken to accommodate adopter preferences.

Park Requested*

Alternate Park optional

Adoption Year (Minimum one year, renewable):*

ADOPTER ACTIVITIES

Litter Control: pick up and remove litter in the park and along adjacent streets monthly or more frequently, if necessary. (Litter control all year - minimum monthly)Park Watch: Report damaged property/equipment, graffiti, fallen trees or other hazards by dialing311, the City of Memphis Call Center. Contact the Memphis Police Department at 901.545.COPS (2677) to report any unsafe or suspicious activity. For life-threatening emergencies, dial 911.Beautification/Landscaping: Must be pre-approved by the Memphis Parks by special written agreement. Opportunities include: weeding, simple pruning, or trail/pathway maintenance. The written agreement must be submitted to and processed by Memphis City Beautiful.

SIGNAGE

Adopters are eligible for a sign featuring their name that will be posted in an area designated and deemed appropriate by the Memphis Parks. If you do not wish to have a sign, please initial here . Signs will be removed upon cancellation and/or termination of the adoption.

ACTIVITY REPORTS

We will measure the success of the Adopt A Park program by requiring participants to track and document their work. For each work activity, adopters shall complete a brief report. Reports are due quarterly to Memphis City Beautiful. Failure to submit the reports could jeopardize your park adoption.

NOTICE OF CHANGES/CANCELLATION

Adopters must notify Memphis City Beautiful in writing of any changes including group or contact information, adopter activities or any special requests. At the end of each adoption year, written notification must be provided as to whether you will renew or cancel your park adoption. Renewal occurs with a new application. Cancellation prior to the one year minimum requirement may prohibit your ability to participate in the future.

AGREEMENT

Adopters must notify Memphis City Beautiful in writing of any changes including group or contact information, adopter activities or any special requests. At the end of each adoption year, written notification must be provided as to whether you will renew or cancel your park adoption. Renewal occurs with a new application. Cancellation prior to the one year minimum requirement may prohibit your ability to participate in the future.

I/We acknowledge and agree to the procedures of the City of Memphis Adopt A Park Program, and understand the nature of the work that is to be performed and take full responsibility for participation in the program. I/We agree to fulfill the minimum requirement for keeping the adopted park litter free and will attend a brief training session. I/we agree to obtain written permission for any landscaping activities and agree to properly dispose of all trash and

I/We understand that the City of Memphis is not liable for any injuries, accidents, or damage that might occur under this agreement.

Signature of Contact Person*

Date*

Date

Adoption of any park is subject to approval by Memphis Parks and Community Enhancement. Memphis City Beautiful serves as primary contact for the Adopt A Park program and is an agency within the Community Enhancement Division.