Defensible Space Chipping Program Application Name (required)Address (required)Phone Number (required)Email (required)Firewise community (name) (required)How large is your property (acres)? (required)Are you the property owner? (required)Owner's name and contact information (if different)Is your property easily found with GPS navigation? If not, please give special instructions on how to reach your property (required)Landowner AgreementI agree to allow SCFSC and the contractor(s) designated by SCFSC under this program access onto my property in order to complete this program. Initial below: (required)I understand and agree that any chipped material will be blown back onto my property. Initial below: (required)I agree to familiarize myself with the above guidelines and I understand that if all protocols are not followed, the contractor may not chip my piles. Initial below: (required)I understand that schedules are determined by SCFSC and its contractor, and that I will be contacted prior to program services beginning. SCFSC will give me a date and timeframe for the chipping to occur, but cannot give me a specific time. Initial below: (required)I agree to ensure that the contractor has access to the piles on my property on the specified date of work. No locked gates! Initial below: (required)I agree to ensure that all people and pets on the premises are kept far away from the chipping work at all times. Initial below: (required)I understand SCFSC is not obligated to provide services under this program and is not liable for its failure to provide such services. SCFSC's funds for this program are limited, and as such they may refuse to provide services to anyone. Initial below: (required)I agree to provide SCFSC with adequate instructions on how to get to my property, if my address is not easily found with GPS navigation. I agree to ensure that my address is clearly marked so that the contractor can find my location. Initial below: (required)In consideration of SCFSC’s free curbside chipping services, I, on behalf of my spouse, agents and representatives, successors in interest, and assigns (collectively “me” or “I”), and any others on the property, including any other occupants, tenants, guests or invitees, hereby agree to waive, release, hold harmless, and refrain from suing Shasta County Fire Safe Council, including its officers, directors, employees, and/or volunteers (collectively “SCFSC Parties”) for any and all claims of liability for injury, death, loss, damage, and/or destruction of any property which is connected in any way with SCFSC Parties services, including provision and coordination of chipping services. Any third-party service providers who perform the actual service of chipping are not covered by this above-stated waiver of liability. Initial below: (required)By typing your full name below, applicant certifies that they are the owner or legal occupier of this property, they have full authority to authorize the SCFSC chipping services, and they agree to the above terms. (required)There was a problem saving your submission. Please try again later.Please wait while your submission is being saved...Submitting...SubmitThank you, your submission has been received.Make sure you know how to properly stack your wood.