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ADOPT-A-FIRE HYDRANT Agreement Application

Fishers ADOPT-A-ROAD Agreement Application
Please complete the following information. Please direct all questions to Amy Crell at crella@fishers.in.us or (317)670-9437
Organization:
Phone:
Address:
Contact Person:
Phone:
Address:
Email Address:
Please list the approximate number of people participating in each clean-up:
By signing below, the above organization or person agrees to a commitment of at least one year, and to maintain their chosen fire hydrant as needed. Also, by signing below, the above organization or person acknowledges the potentially hazardous nature of work.
Electronic Signature:
Date:

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