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  


Search Our Directory

© ACUA 2022 All Rights Reserved.