Adopt a Spot Volunteer Program

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1 Page 1 of 1 Adopt a Spot Volunteer Program Oakland s Public Works Agency, in partnership with our community, provides opportunities for everyone individuals, families, neighborhood groups, civic organizations, employee groups and local businesses to play active and ongoing roles in beautifying, cleaning and maintaining Oakland s neighborhoods, parks and creeks. The Adopt a Spot program accommodates a wide array of volunteer interests and goals. Participants adopt public spaces and make a commitment to regularly clean and beautify the area for no less than one year. Adopt a Spot activities might include: removing litter, graffiti and weeds; gardening; maintaining a drain; and other general upkeep. Your Adopt a Spot packet includes: Adopt a Spot Request Form Adopt a Spot Agreement Volunteer Safety Sheet Volunteer Waiver and Release of Liability The steps to Adopt a Spot are: 1. Fill out the Adopt a Spot Request form and return it to us at the address or fax number shown on the form. 2. A Public Works representative will call you to discuss your site, perform a site assessment and develop a scope of work for the area with you. 3. Your Public Works representative will send you the completed and signed Adopt a Spot Agreement and Volunteer Waiver and Release of Liability. 4. Then you sign and return the completed Adopt a Spot Agreement and Volunteer Waiver and Release of Liability. 5. Don t forget to share the agreement information with everyone who joins you to volunteer. Now you may enjoy your Adopt a Spot experience! If you have any questions regarding the Adopt a Spot program, please call (510) or visit If you would like to become a Park Steward please contact the Oakland Parks Coalition at

2 Page 2 of 2 Adopt a Spot Request Please complete this page and it to AdoptaSpot@oaklandnet.com, fax it to (510) or send it to the address below. Your request will be processed and a Public Works representative will contact you. If you have any questions or special needs, please call (510) Name of Group/Individual: Primary Contact Person: Today s Date: Mailing Address: City: State: Zip: Phone: Fax: Cell: Proposed Scope of Work 1) Please check type of spot to be adopted: Park (name ) Creek (name ) Drain Median Strip Block (curb and sidewalk) Graffiti Other (please list) 2) What is the location or nearest address of your adopted spot? 3) Approximately how often do you plan to clean the site? daily 3x per week 2x per week weekly monthly bi-monthly other: 4) What services will you provide? (Please check as many as you wish) litter pickup weeding planting graffiti removal other 5) Approximately how many volunteers will be working in the spot at any one time? 6) Generally, what day(s) of the week will you work? Time of day? Mon Tue Wed Thu Fri Sat Sun to 7) May we help you recruit additional volunteers by listing your Adopt a Spot contact information in the Public Works Monthly Calendar of Volunteer Events? Yes No Date of Assessment: Notes/ Safety Concerns: Site Approved/Denied By: SITE ASSESSMENT (For Staff Use Only) Date:

3 Adopt a Spot Agreement (To be filled out by Public Works staff after the Adopt a Spot Site Assessment has been completed) Page 3 of 3 Name of Adopting Organization/Group/Individual Name, Location or Nearest Address of Adopted Site TERMS OF AGREEMENT The ADOPTER agrees to: Clean, beautify and maintain the adopted area: daily 3x per week 2x per week weekly monthly bi-monthly other For a period of no less than one (1) year commencing on: Scope of work: Use common sense and follow the practices listed in the attached Safety Sheet Sign and have other volunteers sign the attached Waiver Return any borrowed tools and supplies as agreed Separate collected materials into recycling, greenwaste and garbage Keep foreign mulch and soils off City property Contact the Public Works Call Center (510) to report service requests Contact Call Center (510) for pick-up of City-issued recycling, plant debris and green trash bags. We encourage you to place recyclables and smaller refuse bags into your home refuse containers. OAKLAND PUBLIC WORKS AGENCY agrees to: Assist the ADOPTER in developing a scope of work for the project site Loan tools and supplies to the ADOPTER as necessary Pick up City-issued bags from a designated location Call (510) for pickup. Give closest address to pick-up location. The City of Oakland reserves the right to terminate this Agreement at any time for reasons such as not following through on terms of Agreement, misuse of bags or equipment, etc. Adopting Organization/Group/Individual Contact Person Today s Date Mailing Address Contact s Work Phone Contact s Home Phone Contact s Contact Person Signature Public Works Representative Signature Representative Phone Representative

4 Page 4 of 4 Volunteer Safety Sheet General Safety Wear your own appropriate footwear, clothing and eye protection when necessary. Wear sunscreen and a hat when appropriate. Drink lots of water. Call 911 for emergencies. Always sweep, rake or shovel glass. Never pick up sharp objects with your hands. Do NOT use power tools. Traffic Safety When possible, stay on the sidewalk. Never walk in the street. When working in or around a gutter, work from the sidewalk. If working near traffic, wear a bright reflective work vest or bright colored clothing. Cross streets at signals or crosswalks, not mid-block. Hazardous or Medical Waste NEVER TOUCH HAZARDOUS OR MEDICAL WASTE!!! Hazardous waste includes weapons, toxins (auto fluids, chemicals or paints). Medical waste includes hypodermic needles. Contact your team leader, City staff person or the Public Works Call Center at (510) to report hazardous or medical waste. Working Near Waterways Always work with a partner near water. Watch for poison oak and blackberry thorns. Watch your footing on slopes and shorelines. Never allow children to work on steep slopes or near shorelines without adult supervision. Tool Safety Carry tools carefully to avoid hitting others. Always use the right tools for the right job. Ask a team leader or City staff if you are unsure. Never allow children to play with tools or to use sharp tools. Always keep your tools close to you. Clean your tools before you return them. Count your tools before and after an activity/cleanup.

5 Page 5 of 5 CITY OF OAKLAND Public Works Agency VOLUNTEER WAIVER & RELEASE OF LIABILITY I,, am voluntarily participating in the City of Oakland s Public Works Agency volunteer program at. I acknowledge my participation in these events does not come without the risk of injury or harm; I accept this risk, and assume responsibility for all liability and risk associated with my participation. I agree to hold harmless, release, waive and forever discharge the City of Oakland, its employees, departments, officers and agents, from any and all claims or demands I may have by reason of any accident, illness, injury, loss, destruction or damage to property, arising or resulting directly or indirectly from my participation in this activity. I further covenant not to bring any legal action against the City of Oakland, its employees, departments, officers and agents, for any injury, loss or damage resulting from my participation in this activity. This Waiver and Release is contractual and not a mere recital and applies whether or not injury or loss resulting from this activity is caused by an act or omission of the City, its employees, departments, officers or agents, negligent or otherwise. This Waiver and Release is binding on my heirs, executors, administrators, assigns, and all of my family members, and applies to all losses, whether known or unknown, suspected or unsuspected, related to my participation in this activity. I hereby grant permission to the City of Oakland to use photographs of me taken during this activity on its website and in other publications, at the City s sole discretion and without further consideration. This Waiver and Release was executed on, 2011 at Oakland, California and is valid for a 12 month period from the date of signing. Print Participant s Name Age (if under 18) Signature of Participant Date (If under 18 years old, Parent or guardian must also sign) Signature of Parent or Guardian if participant is under 18 Print Parent/Guardian Name Signature of Parent/Guardian