2. Volunteer Disclaimer

   * Participants under 18 years of age require parental permission and adult supervision

   The Whatcom County Adopt-A-Road Program allows volunteers to enhance the appearance of Whatcom County roadways. Participants are advised that working adjacent to a county road can be hazardous and places the volunteer in potentially dangerous conditions.

   Participants shall exercise due care in performing cleanup activities. Participants shall wear the hard hat and vest furnished by Whatcom County, and other appropriate clothing during cleanup activities. 

   Whatcom County does not provide supervision to volunteer groups and will not assume liability for any accident or injury to volunteers.

   By signature below I acknowledge that I have read this form completely, and I agree to accept the risks connected with this activity. I verify that I am a volunteer, 12* years or older, have viewed the Adopt-A-Road Safety Video (WSDOT) and read and understand the Adopt-A-Road Safety Tips. I also understand the right, responsibilities and privileges of participation in the Adopt-A-Road Program, and on behalf of myself, my heirs and assigns agree to hold harmless Whatcom County and its employees from liability for damages, including injury or death, resulting from my participation this program. 

4. Name of Organization or Group
5. Name of Participant
7. Phone Number
8. Email address
10. Person to notify in case of emergency
11. Relationship
12. Phone Number
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14. 1. Receive an email copy of this form.
15. Email address

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16. Submit

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