Link to Kitsap County's Mission Statement
Public Works - Solid Waste Division
614 Division Street, Port Orchard, WA  MS-27
Phone: (360)337-5777 * Fax: (360)337-4867
 

    

 

 

 

 

 

 

 

 

1-800-424-5555
CALL BEFORE YOU DIG

 

 

 

 

Adopt-A-Road Program
Application Form

We've made it easy to apply!  Fill out the form below and click on submit.  The electronic form will be sent to the Adopt-A-Road Coordinator.  We will contact you with scheduling information and legal documents as follows:

  • Written Agreement - We will ask you to complete an Adopt-A-Road Agreement

  • Safety Orientation - We will provide a brief safety orientation to make certain you are aware of the risks and responsibilities to be assumed by Adopt-A-Road volunteers

  • Liability Release - Each adult volunteer, or parent of minor children, must sign a liability release

  • Medical Coverage - Kitsap County provides excess accident medical coverage, and excess volunteer liability insurance coverage while performing volunteer duties.  Coverage specifics are available upon request.

Name:         

Organization or Group: 

Address:     

City, State:  

Daytime Phone: 

Evening Phone:  

Email Address:  

How many volunteers are 15-17 years old? 

How many volunteers are 18 or older?        

What road would you like to adopt?  Please give the complete road name and the cross roads marking the start and end points.  Roads are assigned on a first-come, first-serve basis after a safety review.

First Choice Road Name:
             From:
             To:   
Second Road Name: 
            From:
            To:    
Third Road Name: 
            From:
            To:    

Staff Contact:  Adopt-A-Road Coordinator

Kitsap County Public Works
Solid Waste Division
(360) 337-5777 or (800) 825-4940
solidwaste@co.kitsap.wa.us

 Updated:  April 11, 2007

Do something positive in your neighborhood

VOLUNTEER ACTIVITY ON-LINE REPORTING

GROUP ACTIVITY
ON-LINE REPORTING