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Adopt-a-Street Application for Program Designation and Agreement

  1. ADOPT A STREET both
  2. Adopt-a-Street

    Application for Program Designation and Agreement

  3. As stewards of the City of Spring Hill water resources, we the above-listed organization, request permission to adopt a segment of the following street:

  4. Designated Representative (Primary)

  5. The work will be performed under and in accordance with the General Program Guidelines and Safety Guidelines and incorporated herein by reference. 

    Applications to whom an Adopt-A-Street Program Designation and Agreement are issued shall at all times indemnify and save harmless the City of Spring Hill, and all employees, agents, and officers from responsibility, damage, or liability arising from the exercise of the privileges granted under designated programs. The Program Designation and Agreement may be terminated by the City of Spring Hill at any time. The City of Spring Hill reserves the right to revise or discontinue the Adopt-A-Street program at any time.

    As a designated representative of the above-named organization/company, I have read, understand, and shall comply with the Adopt-A-Street general program conditions and safety guidelines regarding participation in the program.

  6. Leave This Blank:

  7. This field is not part of the form submission.