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Adopt-a-Roadway Release Form

2. I / We understand that participation in the Adopt-a-Roadway Program litter pickup involves standing and walking near a Township roadway and that there are certain risks involved with such participation. I/We hereby release the Township of Cranberry from any liability associated with the risks involved with participation in the Adopt-a-Roadway Program. I/We have also reviewed the Adopt-a-Roadway safety materials as a prerequisite to participation in the Adopt-a-Roadway Program.

4. Group Name
   *

6. 1. Electronic Signature
   *

8. 2. Electronic Signature
   

10. I / We understand that participation in the Adopt-a-Roadway Program litter pickup involves standing and walking near a Township roadway and that there are certain risks involved with such participation. I/We hereby release the Township of Cranberry from any liability associated with the risks involved with participation in the Adopt-a-Roadway Program. I/We have also reviewed the Adopt-a-Roadway safety materials as a prerequisite to participation in the Adopt-a-Roadway Program.
    *

    1. Yes
    2. No
12. I / We recognize the electronic signature(s) above as an authorized signature of the release form.*

    1. Yes
    2. No
14. 
    

    *If signatory is less than 18 years of age, this must also be signed by a parent or guardian

16. Parent/Guardian Signature

18. I / We recognize the electronic signature(s) above as an authorized signature of the release form.*

    1. Yes
    2. No
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20. 1. Receive an email copy of this form.
21. Email address

    This field is not part of the form submission.

22. Submit

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