Adopt-A-Road Form

Adopt-A-Road

The Adopt-A-Road Program gives volunteers the opportunity to show environmental concern and community pride by “adopting” stretches of roadway within City limits. To combat the amount of trash littered on Salisbury roadsides each day, the program promotes civic pride, environmental responsibility, preserves habitats, improves safety and saves money!

Name*
First Last
Organization (if applicable)
Email*
Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Estimated Number of Volunteers*
Cleanup Event Date*
MM slash DD slash YYYY
Cleanup Event Start Time*

: Hours

Minutes

AM/PM
Cleanup Event End Time

: Hours

Minutes

AM/PM
Any Additional Info We Should Know?
Preferred Cleanup Location
If you do not see your preferred cleanup location in the options below, please enter it in the field labeled 'other'
Other Preferred Cleanup Location
I have read and understand the Activity Liability Waiver*
https://salisbury.md/wp-content/uploads/2025/10/Adopt-a-Road-Waiver-City-of-Salisbury.pdf
- I AGREE
I have read and understand the Program Guidelines*
https://salisbury.md/wp-content/uploads/2025/10/Adopt-A-Road-Overview-AND-Parameters-and-Requirements.pdf
- I AGREE
By submitting this application, I certify that I have read, understand and agree to comply with the Program Guidelines and Waiver. I hereby release the City of Salisbury and its agents and employees from any liability for damages or injuries resulting from participation in any efforts along the City-managed streets, roads, and rights-of-way. The individual, organization, business, entity or person(s) that take part in any efforts coordinated by the City agrees to indemnify and hold the City of Salisbury harmless for any injuries, damages or claims arising from participation in the effort.*
- I AGREE
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