Permission is given to _____________________________________________ of Siletz School to gain access to the Siletz River and its tributaries through my/our property for purposes of measuring fish populations, water quality, and riparian habitat conditions.
Permission is granted:
( ) in perpetuity.
( ) from: ______________ (mo./day/yr.) until ___________ (mo./day/yr.).
Landowner ( ) waives ( ) retains right to be present or have a representative present during educational activities.
Permission ( ) is not ( ) is restricted to the following days and/or times:
Access will be granted by way of agreed upon routes, or as mapped in appended document. This permission may be revoked at any time with written notification or for just cause.
Other conditions of use (if any) include:
Landowner____________________________ Date_____________
Signature____________________ Name____________________
Siletz School Signature__________________________________
Name___________________ Title __________ Date___________