IMMP Landowner Waiver & Release of Liability

IMMP Landowner Waiver & Release of Liability

Monarch Joint Venture - Integrated Monarch Monitoring Program
STEP 1. Field observer(s) ("Permittee") complete the section below and click Submit at the page bottom. This sends the partially-completed form to the Landowner/Representative's email.

The Permittee hereby waives all claims against the Landowner, its officials, employees, and representatives for injuries or damages incidental to, connected with, or arising out of Permittee’s access to the Property. Each party shall be responsible for its own acts and behavior and the results thereof.

The Permittee understands that entry and access to the Property may be hazardous and that injuries or damages may occur in the normal course of accessing the Property. The Permittee assumes all risks and hazards incidental thereto by Permittee’s employees and representatives.

The Permittee has permission to enter the Property to collect milkweed, nectar plant, and monarch data at the frequency and duration noted below. No specimens will be collected with the exception of plant material as needed to aid in species identification.
Field Observer Name ("Permittee")*

First NameLast Name
Permittee Organization
Permittee Signature*
Landowner or Representative Name ("Landowner")*

First NameLast Name
Landowner Organization/Agency
If applicable
Property Address ("Property")*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Landowner/Representative Phone Number
Landowner/Representative Email Address*
STEP 2. Landowner/Representative complete the section below. Click Submit to finalize the waiver.

In consideration for allowing the "Permittee" and its organization's staff or volunteers to enter the "Property" for the purposes of monitoring milkweed, nectar plants, and monarchs:
Through what date may the Permittee collect monitoring data at the Property?

MonthDayYear
Date
May the Permittee collect a subsample of monarch caterpillars from the Property to rear to adulthood for the purposes of this research? (For California, mark "No.")

YesNo
How should the Permittee contact you, the Landowner, in regard to monitoring visits?

PhoneEmailTextOther
Please describe any communication preferences (e.g., contact 1 week prior to surveys, use email, call after 5pm)
Data collected from the Property are submitted to the Integrated Monarch Monitoring Program, a national dataset of monarch and vegetation information. Biological and management data are available to researchers upon request to and approval from the Monarch Joint Venture. No personal contact information is shared, and researchers are prohibited from using or mapping data in any way that would identify parcels or landowners.

I acknowledge that data collected from this site are submitted to the Integrated Monarch Monitoring Program, a national database of monarch and vegetation information, and that the dataset is available to researchers upon request to and approval from the Monarch Joint Venture.
Landowner/Representative Signature
Please note any preferences for contact prior to surveys, survey limitations, parking, access, etc.
Should be Empty: