GRAFFITI REMOVERS RELEASE FORM

I  (print name here)                                                                        , am the owner of the property located at the following address:

(number and street)

(city, state, zip code)

As the owner of the property, I do not need anyone else’s permission to allow work to be done or to sign this form. I give permission for ________________________ and their agents and contractors to come on my property to remove or cover the graffiti using methods they decide are best. ("Graffiti Work") I release __________________________ and their agents and contractors from any claims or damages related to the Graffiti Work on my property.

I understand that only the area covered by graffiti will be cleaned or painted and not the entire building. I understand that there are no promises being made to me about the color or quality of the services or material used in doing this Graffiti Work. I also understand that by signing this form I give _____________ and its agents and contractors permission to remove the graffiti from my property but that they are not obligated to do so. I also understand that if graffiti returns to my property during the time period checked below, ___________________________ and its agents and contractors may also remove this graffiti but has no obligation to do so.

(Property Owner/signature)                                                                             

(Date signed)                                                       

Duration of Consent:      1 Year [  ]

(Daytime Telephone Number)                                                                                 

Type of Structure: apartment, house, fence, garage/door, building walls, stucco walls, security gates: