- I, having made application to the Village of Cuyahoga Heights, Ohio, for it to provide me with certain snow removal services, said application being here to and made a part there of, understanding that the Village streets will be plowed first, that at least 2-4 inches of snow must fall, & and at the direction of the service director that under certain unforeseen circumstances, manpower or equipment may be limited, that under severe weather conditions plowing may take longer, that access to the drive must be provided by the resident, and that other unforeseen rules may apply, do hereby grant permission to the Village of Cuyahoga Heights, its officers and employees, to come upon my private property, the address of which is listed below, for the purposes of removing snow there from, and also, by these presents, I, in consideration of the Village's approval of my application for snow removal services, and in consideration of the Village providing snow removal services to my property, I hereby forever completely release and discharge the Village of Cuyahoga Heights, Ohio its successors and assigns, and officers and employees, from all claims, demands, damages, actions, and causes of action whatsoever, which I may now have or may have as a result of or arising out of the Village of Cuyahoga Heights providing snow removal services to my property.

- I, the undersigned, have executed this consent and release on the day and year appearing after my signature. This release is in effect until at which time the owner or renter changes from the listed address.

- I acknowledge that this is a rental property and a form must be submitted by both the Owner and the Renter before the service can be provided.

CONSENT TO ENTER UPON PROPERTY FOR SNOW REMOVAL

AND RELEASE OF ALL CLAIMS AGAINST

THE VILLAGE OF CUYAHOGA HEIGHTS POSSIBLY ARISING THERE FROM