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2. Thank you for taking such a huge step into the betterment of the City of Missoula. By adopting a Traffic Circle you are not only beautifying your neighborhood, but you are also beautifying our City!
   
   Please email us at contact@missoula-neighborhoods.org with any questions.
4. First Name
5. Last Name
7. Address
9. City
10. State
11. Zip
13. Email Address
15. Phone Number
17. Location of Traffic Circle Request:*
    (Please be specific)
19. Sponsoring Organization/Individual*
20. Can we use your name on the website as an adopter of a circle?
    -- Select One --YesNo

    Select yes or no.
22. By signing here you are agreeing to adopt a Traffic Circle for at least two year term.*
    Typed Name Required (You may reapply following the conclusion of a two year term)
24. Adopt-A-Traffic-Circle Volunteer Release and Waiver
    Every individual participating in a City of Missoula Adopt-A-Traffic-Circle activity shall sign a copy of this agreement form and fill out the volunteer release and waiver prior to any work on City property. The forms should be returned to the Office of Neighborhoods. The individual listed below recognizes the inherent risks associated with participating in work programs such as Adopt-A-Traffic-Circle program. The individual below shall indemnify and hold harmless the City of Missoula, its officers, employees, agents and elected officials from and against any and all claims, suits, actions or liabilities of any nature, including but not limited to injury or death of any person, loss or damage to property, or any other basis whatsoever, arising out of the use of city property or participation in this Adopt-A-Park or Adopt-A-Trail program resulting from any act or omission, or thing done, permitted, or suffered to be done, by the organization/individual, except claims, suits or actions occasioned by the sole negligence of the City of Missoula.
26. By signing here you are agreeing to sign the "Adopt-A-Traffic Circle Volunteer's Release and Waiver"*
    Typed Name Required
28. Comments*
30. For more information on Adopting a Traffic Calming Circle in Missoula
    Missoula Traffic Calming Circles

    Please follow the link above
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32. 1. Receive an email copy of this form.
33. Email address

    This field is not part of the form submission.

34. Submit

* indicates a required field