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2. The City of Frederick’s Adopt-A-Road Program (Program) provides a way for community groups to show their City pride and help keep our roads litter free. Keeping our roadways clear of litter also improves the health of our waterways. The City of Frederick’s Adopt-A-Road Program will begin in Fall 2020.
4. How the Program Works:
   City of Frederick approved groups may participate in this Program. Groups agree to adopt a 1-mile stretch of roadway to clean at least 4 times a year. At least one member of the group must be 18 years old or older. Youths 12-17 years old are allowed to participate with adult supervision. However, for safety reasons, children under the age of 12 are not permitted to participate in roadside litter clean-up events. The City of Frederick will provide your group with safety vests, trash bags, and first aid kit. The City also will place signs recognizing your organization at both ends of the adopted roadside.
   Adopt-A-Road groups are required to clean up trash a minimum of 4 times per year but are permitted to clean the roadside more often.
6. Getting Started
   The Adopt-A-Road Coordinator (Coordinator) will guide you through the process, identify a stretch of road to adopt, and provide you with supplies for your group. All participants or guardians must sign a liability waiver. You are responsible for maintaining the vests and other supplies for your group and requesting additional bags when needed. The City of Frederick will provide temporary “Shoulder Work Ahead” signs each time the group performs a cleanup. One week before organizing your group’s cleanup, contact the Coordinator to arrange for signs to be dropped at the cleanup location. City of Frederick staff will retrieve them and the trash after the cleanup is completed.
9. Adopt-A-Road Agreement
11. In consideration of the mutual benefits received by the City and the Group from participation in the City’s Adopt-A-Road Program, the Participant hereto agree as follows:
13. Group Name:*
15. 1. The term “Group Leader” means the person responsible for the management of the Adopt-A-Road Program at the Group level. The term “Participant” means any individual member of a Group who wishes to take part in a Group’s litter pick-up.
    2. The Group and its Participants will adhere to the Guidelines, Responsibilities and Safety Procedures attached hereto and incorporated herein as Exhibit A.
    3. The Group shall consist of a minimum of two people. However, when any Participant is between the ages of 12-17, the minimum group size shall be three people. Children under the age of 12 are not permitted to participate.
    4. Groups must leave their bags of litter and other items they have removed from their adopted section of road between the two recognition signs for the City to remove.
    5. The Group Leader and all Participants agree to pick up litter on the above described section of road in accordance with the Guidelines, Responsibilities and Safety Procedures attached hereto and incorporated herein as Exhibit A.
    6. The City agrees to provide the services and equipment as outlined in Exhibit A.
    7. Either party may terminate this Agreement for any reason, upon 30 days written notice to the other party.
    8. Notwithstanding any other provision of this Agreement, the City reserves the right to modify this Agreement at any time. All modifications shall be in writing and shall be effective upon the City’s email communication to the Group Leader at the specified email address below.
    9. The Group is aware of the potentially hazardous nature of the work to be performed. Except to the extent any injury or damage is caused by the active negligence of the City, the Group waives any claim for any injury or damage arising out of the Group’s participation in the Adopt-A-Road Program.
    10. The Group and each Participant hereby releases the City, its agents, and employees from any liability for damages or injuries resulting from its participation in the City of Frederick Adopt-A-Road Program. The Group furthermore agrees to indemnify and hold the City harmless for any injuries or damages resulting from or related to its participation in the City of Frederick Adopt-A-Road Program.
    11. Signatures below reflect concurrence with all guidelines in this City of Frederick Adopt-A-Road Agreement.
17. City of Frederick Adopt-A-Road Leader/Participants *

    1. Leader

    1. Participant
19. Full Name:*
20. Group Name:*
22. Signature:*
23. Date:*
    Date:
25. Address:*
26. Contact Number/Email:*
28. Signature of Parent/Legal Guardian (Required of Participants under the age of 18):*
30. *You are signing this statement agreement electronically. By signing above, you agree your electronic signature is the legal equivalent of your manual signature on this agreement.
32. Guidelines, Responsibilities and Safety Procedures
34. Adopt-A-Road Leader Guidelines
    1. Provide completed Agreement to the City Adopt-A-Road Coordinator before participation to verify that all requirements and safety conditions are understood and followed.
    2. Ensure that litter pick-up is performed only by those Participants who have submitted a signed Participant Agreement to the City Adopt-A-Road Coordinator.
    3. Provide one week notice before clean-up to allow Coordinator to arrange safety signage and trash hauling following the event.
    4. Report to Coordinator following each cleanup via email with number of participants, hours dedicated to the cleanup, and number of bags and any bulk items that might need special care.
    5. Perform litter pick-up on both sides of the roadway at least 4 times per year, preferably April, June, August, and October.
    6. Maintain at least one adult, 18 years of age or older, for every five Participants between the ages of 12 and 17.
    7. Participants between the ages 12 and 17 must have parental or guardian consent. Children under the age of 12 are not permitted to participate.
36. City of Frederick Responsibilities
    1. The City Adopt-A-Road Coordinator will determine eligible sections of roadway with input and initial preferred road selection from the Group Leader.
    2. The City may reject a Group’s application to participate in the Adopt-A-Road Program, cancel an existing Agreement, deny the renewal of an application to participate, or prohibit an individual from participating in a Group’s litter pick-up based on any of the following determinations by the City of Frederick:
    a. The Agreement is incomplete or contains false information;
    b. The Group or Participant fails to comply with the safety guidelines;
    c. The Group or Participant fails to comply with its responsibility to pick up litter in the adopted section of roadway at least 4 times per year;
    d. The Group understands and agrees that discrimination in any manner by the Group against a member or applicant for membership, or any person, including members of the public and City of Frederick employees encountered while participating in the Program, on the basis of race, color, age, religion, sex, gender, national origin, sexual orientation, gender identity, marital status, physical or mental disability, or any other status protected by law is prohibited; and
    e. The Group’s participation is impacting or would impact the safety of other Groups or Participants in the Program, passing motorists, or City employees.
    3. In return for the Group’s participation, the City of Frederick will provide the Group with:
    a. Two Adopt-A-Road signs on the designated roadway with the approved Group name.
    b. Reflective safety vests and a supply of trash bags for all individuals who have submitted their Participant Agreement form at least one week before the next event.
    4. The City of Frederick will remove all trash reported to the Adopt-A-Road Coordinator.
38. City of Frederick Adopt-A-Road Program Safety Procedures
    To protect yourself and others while picking up litter, be sure to SET UP ROADSIDE “SHOULDER WORK AHEAD” SIGNS TO ALERT DRIVERS TO USE CAUTION. Safety Procedures MUST be reviewed with the entire group prior to EVERY cleanup.
    1. Park all vehicles clear of the roadway.
    2. Wear a safety vest at all times.
    3. Wear proper clothing for the weather and hard-soled shoes. Do not wear open-toed shoes. Avoid exposure to the sun, poisonous plants and insects. Long-sleeve shirts are recommended.
    4. Post the roll-up signs before any work is conducted.
    5. Work as a group, facing oncoming traffic at all times.
    6. Provide supervision for any Participants 12-17 years of age. No children under age 12 are permitted to participate.
    7. Only work during daylight hours and favorable weather conditions.
    8. Stop work in inclement weather, for all emergency vehicles until they have passed or cleared the area, or in the event of a vehicle accident in your section of roadway.
    9. Avoid overexertion and stay well-hydrated. Always keep the City-provided First Aid Kit onsite for each clean-up event.
    10. Do not remove animal carcasses or hazardous substances; report them via email to the Coordinator with your event report. Illegal items are to be reported to the City of Frederick Police and left where they are found.
    11. Stay clear of any construction sites and obey site officials.
    12. Do not enter the travel portion of the roadway, tunnels, or clean on bridges/overpasses. Use crosswalks when necessary.
    13. NEVER participate or allow participation by anyone who is under the influence of alcohol, recreational drugs, or new medications.
    14. Do not distract motorists with horseplay or abrupt, erratic movements.
40. REMEMBER: YOU ARE WORKING IN A DANGEROUS ENVIRONMENT--A PUBLIC ROADWAY.
42. After the Group Picks Up Litter
    1. Roll up the “Shoulder Work Ahead” signs and leave them onsite near one of the Group’s Recognition Signs.
    2. Bags must be securely knotted or tied to prevent litter from falling out and placed between the Group’s Recognition Signs for the City to remove.
    3. The Group Leader must notify the Coordinator on the next business day via email to report number of volunteers, hours, amount of litter picked up, and bulk items collected.
    4. Request additional bags, vests, and gloves if needed.
44. 1. I have read the Agreement and agree to the terms for each subsection in this part.
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46. 1. Receive an email copy of this form.
47. Email address

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48. Submit

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