Agreement NumberAdopt-a-Road Agreement • May 4th, 2011
Contract Type FiledMay 4th, 2011This section to be completed by Municipality Staff The Town of Erin Roads Department recognizes the group/individual named below as responsible for the adoption of Road No. from toa distance of kilometres. The group/individual named below volunteers to pick up litter at least once a year along its adopted section road beginning and ending ensuring that litter pick-ups do not occur on the following dates: Municipality Representative Signature Position Title Date Telephone This section to be completed by the Authorized Group Representative I (We)Name of group or individual Agree to adopt the section of road indicated above and keep it clean as per the terms and conditions of the Adopt-A-Road agreement. I have read the brochure “Safety Guidelines for Volunteers, Adopt-A-Road Program” and will share this information with all individuals who participate in the program. Authorized Group Representative (Print Name) Signature Address DateIs this an Agreement Renewal?City Postal Code Yes