* 1. Name of the Caretaker (First Name, Last Name)

* 2. Phone number of the Caretaker

* 3. Email address of the Caretaker

* 4. This section displays all Caretaker responsibilities. The required behaviors of all Caretakers are listed below. To agree to the terms of this section, you must check each box to signify that you agree with the corresponding responsibility. Caretakers must agree to all terms in order to successfully register.

* 5. This section displays all City of Fort Worth responsibilities. The City will behave in accordance to the responsibilities outlined below. Review the terms of this section, you must check each box to signify that you understand the corresponding responsibility. Caretakers must agree to all terms in order to successfully register.

* 6. Enter your electronic signature (type your full name) in the box below to signify that you (The Caretaker) have read, marked, and fully understood all responsibilities discussed in this form.

T