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Public Works Department 621 Lagoon Road Belgrade, MT 59714 Phone: [PHONE REDACTED] www.belgrademt.gov 1 Belgrade Hometown Heroes Program – Legal Agreement - Volunteer This Hometown Heroes Program Application Agreement (this “Agreement”) is created and effective as of the date of the VOLUNTEER’s signature on this Agreement. WHEREAS, the Hometown Heroes Program is the City of Belgrade’s (“City”) volunteer program for removal of sidewalk snow and ice removal service for older neighbors, veterans, and those with temporary or permanent disabilities, who do not have the means to remove their own snow and ice (“Service”); WHEREAS, VOLUNTEER has applied to the City for participation in the Hometown Heroes Program as a volunteer to provide the Service; NOW THEREFORE, the undersigned VOLUNTEER hereby acknowledges and agrees as follows: I. HOMETOWN HEROES REQUIREMENTS AND RULES VOLUNTEER certifies that VOLUNTEER is capable of removing snow and ice from a sidewalk. VOLUNTEER understands that the only service provided will be sidewalk snow and ice removal. VOLUNTEER understands that the VOLUNTEER’s participation in the Hometown Heroes Program shall not include any interactions or communications with the recipient of the Service except to the extent necessary to perform the Service, unless the VOLUNTEER has provided express written consent to receive direct communications from the applicant. VOLUNTEER also understands that the Service requires no entry inside the residence of the recipient of the Service, and VOLUNTEER shall not enter the inside of the residence of the recipient of the Service for any reason. VOLUNTEER understands that they are participating in a voluntary program; VOLUNTEER is not an employee of the City and is not acting as an agent on behalf of the City. VOLUNTEER acknowledges that they are being asked to remove snow and ice before noon (12:00 PM) the next day following snowfall, in accordance with the Belgrade City Code Title 7, Chapter 3. However, the applicant remains responsible for snow and ice removal should the VOLUNTEER(s) fail to appear and/or fail to properly remove snow or ice. VOLUNTEER agrees to treat any and all Hometown Heroes recipients with dignity and ---PAGE BREAK--- Belgrade Hometown Heroes Program Legal Agreement - Volunteer www.belgrademt.gov 2 respect, or risk expulsion from the Hometown Heroes Program at the complete discretion of the City. VOLUNTEER understands that the City reserves the right to withdraw support for or terminate VOLUNTEER at its sole discretion, at any time, for any reason. II. RELEASE AND HOLD HARMLESS VOLUNTEER agrees to assume all risk of injury, harm, or damage to VOLUNTEER’s person or property which may arise as a result of the performance of the Service and does hereby release and agree to indemnify and hold harmless the City, its agents, officers, and employees from any and all liability actions, damages, and claims of any kind and nature whatsoever for injury or harm that might arise in connection with the use of the Service. VOLUNTEER further agrees that Section II of this Agreement is intended to be as broad and inclusive as is permitted by the law of the State of Montana and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect. VOLUNTEER further agrees that no oral representations, statements, or inducements apart from this Agreement have been made. IN WITHESS WHERE OF VOLUNTEER or VOLUNTEER’s duly authorized representative has agreed to this Agreement. ---PAGE BREAK--- Belgrade Hometown Heroes Program Legal Agreement - Volunteer www.belgrademt.gov 3 Volunteer (print) Volunteer Signature Date If VOLUNTEER is under the age of 18, consent of a parent or legal guardian is required to participate in the Hometown Heroes Program. Parent or Legal Guardian (print) Parent or Legal Guardian Signature Date Public Works Department Review Initials: Date: