Permission Slip for Participants 18 Years of Age or Under


I hereby acknowledge that  is at least 11 years old and has my permission to participate in the Atlantic County Clean Communities Adopt-A-Road Program, which requires her/him perform periodic litter pick up along a county roadway. I acknowledge that any medical costs for injuries sustained by my child while participating in this program are my responsibility.

Parent / Guardian:
Date:  [None] Select a Date Delete the Date  


                    

 
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