Adopt a Roadway Program

The Adopt-A-Road Program is an anti-litter campaign intended to build a volunteer spirit and foster community pride in Whitestown. It allows citizens, organizations and church or civic groups to work in partnership with the Town by adopting a segment of roadway and agreeing to keep it clean.

This program offers individuals and groups an inexpensive way to contribute to their community and generate publicity for their efforts. Every participant in this program makes a positive impact on the appearance of the road system and their community.

Get Started

NOTE: Maximum number of total participants is 20. All volunteers are required to be 12 years old or older. When participants are 14 years of age or younger, the Group shall furnish minimum supervision of 1 adult to every 4 children (1:4 ratio). Accept responsibility to provide direct and responsible adult supervision for those minors not accompanied by a parent or guardian. All participants are required to sign a waiver and agree to hold harmless the Town of Whitestown and employees from all liability, judgment, costs, expenses and claims growing out of damages or alleged damages of any nature whatsoever to any persons or property arising from the performance or non-performance of roadside work.

The Town of Whitestown will install sign(s) for your road segment within 90 days of completing your first clean up. Sign placement, size, content, location and scheduling of installation are at the sole discretion of the City.

Applicant Information

Organization or Applicant(Required)

Contact Name or Responsible Party(Required)

Work or Cell Phone(Required)

Email Address(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Location Information

Application Date(Required)

Request Type(Required)

New

Renew

Roadway Preferences(Required)

Please list three sections of roadway in order of preference. Assignments will be based upon availability and the rules and regulations of the Adopt a Roadway Program.

Terms of Participation

I have read and reviewed all agreements and associated documents and understand the terms of our participation. The undersigned agrees that the work will be done in accordance with the Town of Whitestown and Regulations and participation is subject to inspection and approva

Please check box to indicate you have read and reviewed all agreements and associated documents.(Required)

Yes = I agree

Signature(Required)

Office Use Only

Assigned Roadway

Date

Approved By

Phone

This field is for validation purposes and should be left unchanged.

Documents

Getting Started
Program Information
Safety Procedures
Participant Waiver, Release and Indemnity

Adopt-a-Roadway Statement of Commitment

The Adopt-a-Roadway Program is a partnership between the Town of Whitestown and citizens of the Town to care two mile segment of road in an effort to make Whitestown a better place to live. Both the Town and the individuals or groups adopting the road(s) make a commitment to each other to perform certain activities for keeping the neighborhoods clean and safe.

The Adopter agrees to:

Remove litter along the designated section of a Town road for a minimum of four times a year for a minimum of two years. Obtain a signed waiver and release form. The organization shall deliver the signed forms(s) to the Town of Whitestown Volunteer Coordinator prior to the activity and, as necessary, prior to any subsequent cleanup activity. Only those individuals who have signed the release and disclaimer forms(s) may participate in the cleanup activities. For individuals under the age of 18, a parent or legal guardian must sign the waiver and release form on behalf of such individual.
Assure that all participants are responsible individuals, and that participating minors are supervised by a parent or legal guardian.
All volunteers are required to be 12 years old or older.
When participants are 14 years of age or younger, the Group shall furnish minimum supervision of 1 adult to every 4 children (1:4 ratio).
Accept responsibility to provide direct and responsible adult supervision for those minors not accompanied by a parent or guardian.
Discuss safety precautions with project participants, make sure that participants sign in for each clean up, confirm each participant has a waiver on file, and assure that all borrowed equipment and unused supplies are returned to the Adopt-a-Roadway Program following the completion of each project.
Schedule clean ups at least one week in advance. Submit clean up report by the end of the month.
Adhere to all safety guidelines provided, including to avoid potentially hazardous items such as heavy objects, car batteries, needles, animal bodies or any other object that appears to be questionable.
Appoint or select an authorized representative to serve as the spokesperson/coordinator. If the spokesperson/coordinator changes the Group will assume responsibility to inform the new representative of the Adopt-a-Road Program requirements and update their contact information with the Town of Whitestown.

The Town agrees to:

Provide and install up to two Adopt-a-Roadway signs (one for each direction of traffic) with the Adopter’s name on each sign, within 90 days after the first cleanup has been completed.
Provide certain safety equipment (e.g. litter bags, safety vests etc.), written safety instructional material and dispose of the filled litter bags dropped off at the Whitestown Municipal Complex.

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