Lanark County’s Adopt-A-Road Program has been established as a public service program for volunteers to enhance the local litter collection and invasive plant and noxious weed management activities of the County by conducting approved activities within a section of county road right-of-way. It is a way for environmentally conscious citizens/groups to make a contribution to a better environment and more beautiful County Road System.
The persons associated with the group named below intend to enhance the environment and improve the appearance of a section of a county road right-of-way by carrying out activities as indicated below, under the Terms and Conditions of the Adopt-a-Road Program.
New Application Renewal
Name of Group / Individuals:
Number of Volunteers: (minimum of 3 required)
Contact Information: (Group Coordinator)
Type of Group: (please check the closest match)
☐ Church Group
☐ Community / Service Club / Group
☐ Family / Friends
☐ Individual(s) ☐ Business
☐ School Group
Sign Information: (New applicants only)
We request the following information to appear on the Adopt-A-Road sign:
Our group has a logo and a picture of it is attached. Electronic file will be provided when the adoption agreement is approved.
Provide wording to identify your group (2 lines – 10-12 characters in length)
Page 1 of 3
Activities to be completed:
[X] Litter Pick up (Mandatory Participation)
[X] Spotting and Reporting Invasive Plants and Noxious Weeds (Mandatory Participation) Hand Pulling / Spading Invasive Plants and Noxious Weeds
Landscape Planting / Seeding Accelerated Mowing
Use of residential tools (residential riding lawn mower, push mower, hand tools) Large Mechanical Mowing Equipment
If doing vegetation control activities, do you wish to compost the plants? Yes No
(If yes, a proposal must be attached outlining how and where you will complete the composting)
County Road Information: (Road sections are adopted on a first come, first served basis)
Road #: Road Name:
From: _ To:
Side of Road: Both Sides OR Specify:
A Distance of: Kilometers (Generally a minimum of 2 kms in length)
The work will be performed in accordance with the County of Lanark’s Adopt-A-Road Program Terms and Conditions and to meet the agreement objectives, both attached to this agreement and incorporated herein by reference. This agreement shall not be amended or modified in any respect otherwise than in writing and executed by the parties.
Prior to participation in the Adopt-A-Road Program, Applicants with whom agreements are made, as well as their Volunteers, shall sign a Waiver and Acknowledgment of Risk and shall at all times defend, indemnify and hold harmless the Corporation of the County of Lanark and its elected officials, employees, agents and officers, from any responsibility, damage or liability arising from the exercise of the privileges granted the Adopt-A-Road Program Agreement and their participation in the Adopt- A-Road Program.
The Corporation of the County of Lanark will monitor the Adopt-A-Road Program and all individual agreements to determine if the program’s overall objectives are being met. The County reserves the right to cancel the program in a given area or to terminate an agreement for any reasons, including but not limited to the following: inadequate performance, potential harm to public image of the County or the Program, non-compliance with the terms and conditions, conduct of the adoptee group or individual or individuals involved in the adoptee group, or revisions or termination of the program.
The County will not conduct herbicide application within adopted road sections where invasive plant and noxious weed control activities are being performed in accordance with the Terms and Conditions of the Adopt-A-Road Program AND where the objectives, as set out in the individual agreements, of invasive plant and noxious weed activities are being achieved.
Page 2 of 3
The County also reserves the right to limit the number of adoptions for a single group or entity.
I have read and I understand the Adopt-a-Road Program Terms and Conditions for participation in the Program. I understand that each individual volunteer must complete a Volunteer Waiver and Acknowledgement of Risk form prior to commencing any volunteer activity. I understand that, where applicable, evidence of insurance as outlined in the Adopt-a-Road Insurance Requirements must be provided to the County prior to the group commencing any volunteer activity.
Applicant’s Signature: Date:
Print Name: (Group Coordinator)
THIS SECTION TO BE COMPLETED BY THE AUTHORIZED COUNTY REPRESENTATIVE
Permission is hereby granted to “adopt” a section of county road, specifically,
Is this the section of road the group originally applied for: ☐ Yes ☐ No
County Road # _ Name:
The section begins: and ends at
for a total of kilometers.
The activities approved for this adoption agreement are:
[X] Litter Pick up (Mandatory Participation)
[X] Spotting and Reporting Invasive Plants and Noxious Weeds (Mandatory Participation)
☐ Hand Pulling / Spading Invasive Plants and Noxious Weeds
☐ Landscape Planting / Seeding
☐ Accelerated Mowing
☐ Use of residential tools (residential riding lawn mower, push mower, hand tools)
☐ Large Mechanical Mowing Equipment
Term of this adoption is: From: _ To:
Reason: (If an activity is not approved)
[X] Adoption Agreement Objectives are attached and form part of this Adoption Agreement.
Composting Proposal Approved: ☐ Yes ☐ No (If yes, the proposal, including any amendments, must be attached to, and form part of, the Adoption Agreement Objectives.
Director Public Works Date
Page 3 of 3