NCVMG CONSENT & RELEASE FORM
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_____________________________ (ANGEL'S NAME)
I UNDERSTAND NCVMG IS A PUBLIC PARK AND EVERYONE IS WELCOME
_______(INT)
I UNDERSTAND NCVMG IS NOT RESPONSIBLE FOR ANY DAMAGE AND OR THEFT TO YOUR PLAQUE
_______ (INT)
*** PLAQUES INCLUDED *** ANGEL PLAQUES, WALKWAY PLAQUES, NEVER FORGOTTEN PLAQUES,
SPONSOR PLAQUES, BENCH PLAQUES, MONUMENT PLAQUES AND ANGEL STATUE PLAQUES.
NCVMG GARDEN HOURS ARE POSTED BY CORPUS CHRISTI PARKS AND RECREATION
PLEASE DO NOT VIOLATE CORPUS CHRISTI PARKS AND RECREATION RULES:
3102 OCEAN DR CORPUS CHRISTI TEXAS 78404 (LOCATION OF GARDEN)
THIS CONTRACT IS FOR THE NUECES COUNTY VICTIMS MEMORAL GARDEN, HERE FORWARD KNOWN AS (NCVMG). ONCE WE DONATE AND PLACE YOUR PLAQUE IN THE GARDEN ONLY NCVMG HAS THE RIGHT TO REMOVE A PLAQUE FROM THE GARDEN.
BY SIGNING THIS I UNDERSTAND I AM FULLY WAIVING MY RIGHTS TO NCVMG DECISIONS AND NCVMG HAS NO RECOURSE FOR THESE ACTIONS.
BY SIGNING THIS AGREEMENT, I FULLY UNDERSTAND THIS AND WAIVE ANY AND ALL LEGAL ACTION AGAINST NCVMG IF MY PLAQUE IS REMOVED BY NCVMG. I AGREE TO RELEASE ALL RIGHTS.
I HEREBY GIVE FULL CONSENT AND DONATE THIS PLAQUE AND HEREBY SWEAR AND AFFIRM I HAVE PERMISSION TO DO SO REGARDING THE NAME AND PHOTOGRAPHIC REPRESENTATION OF THE INDIVIDUAL ON THE PLAQUE.
IF REMOVAL OF PLAQUE OCCURS, IT WILL BE RETURNED TO THE PERSON NAMED ON THIS AGREEMENT BY NCVMG.
NO REFUNDS ARE ISSUED OR ENTITLED AFTER PLAQUE IS ORDERED.
________(INT)
*** BY SIGNING THIS CONSENT & RELEASE FORM DOES NOT GUARANTEE PLACEMENT OF PLAQUE(S) ***
I HAVE READ THE QUALIFICATIONS FORM AND UNDERSTAND AND AGREE TO OUR TERMS:
________(INT)
NCVMG CONSENT & RELEASE FORM
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______________________________SIGNED
______________________________PRINT
RELATIONSHIP TO VICTIM? ____________________________
DATED ____/____/____
______________________________NCVMG REPRESENTATIVE
______________________________SIGNED
______________________________PRINT
DATE ____/____/____
NCVMG OFFICE:
NONPROFIT ORGANIZATION 501(C)(3)
3536 S. PADRE ISLAND DR CORPUS CHRISTI TEXAS 78415
(361)236-0164 (OFFICE/CELL)
(361)452-3157 (FAX)
NUECESCOUNTYVMG@GMAIL.COM (EMAIL)
NUECESCOUNTYVMG.ORG (WEBSITE)
CAUSE OF DEATH:
( PLEASE CIRCLE AND BRIEFLY EXPLAIN)
HOMICIDE
MANSLAUGHTER
DIED BY SUICIDE
MUST BE SIGNED AND DATED
MAIL TO US @ 3536 S. PADRE ISLAND DRIVE CORPUS CHRISTI TEXAS 78415
EMAIL TO US @ NUECESCOUNTYVMG@GMAIL.COM
FAX TO US @ 361-452-3157
DROP OFF AT THE NCVMG OFFICE ADDRESS SAME AS MAILING
THANK YOU, FALLON WOOD ( PRESIDENT/FOUNDER )