Provided by Good Neighbor Law
P.O. Box 155
LaSalle, CO 80645

Please consider this signed agreement as permission granted to:

_________________________________________________________________Grantee

Address: ________________________________________________________________

To be admitted on the property of: _________________________________________________________________Grantor

And to be confined only to: _______________________________________________________________________
 
Please check one of the following:  Private citizen_________ Public Servant________
(In addition to this agreement, Public Servant will be required to fill Public Servant’s Questionnaire pursuant to the Privacy Act of 1974, and attach to Grantor’s PAA.)
 
Grantee accepts full responsibility of his/her actions while on said property, and thereby waives Grantor of any liability what so ever.
 
Grantee agrees that he or she is a guest on Grantor’s property, accepts burden of performance, and acknowledges any action not agreeable to Grantor authorizes Grantor opportunity to terminate agreement.
 
Grantee promises to: Notify Grantor prior to each time Grantee desires to enter property; exercise full consideration of this privilege granted; will be absolutely observant of keeping shut gates shut, not leave behind any material Grantee brings in; not remove any material from Grantor’s property; not intentionally bring damage to any part of the land, water, farm animals or livestock, and not move beyond area defined in agreement.
 
This agreement is non-transferable, and on a one-person only basis.
 
Grantee must have agreement available to show Grantor or any person Grantor authorizes to request show of said agreement, and if Grantee fails to show requested agreement, Grantor and Grantor’s authorized person will hold right to demand Grantee leave of property immediately.
 
Agreement terminates at the end of one year from the date below.
 

Signed (Grantee) ________________________________________________________________

 
Signed (Grantor) _________________________________________________________________

 
Date____________________________________________________________________