Safety Procedure Form

 I, , the leader representing  have reviewed the Adopt-A-Road Guidelines and the "Manual of Uniform Traffic Control Devices" and have been briefed on proper safety procedures. I agree to enforce the procedures and guidelines listed  and to put the safety of myself and fellow group members above all else. I understand the dangerous nature of a roadside cleanup and agree to take full responsibility for any injury or damage that might occur to me or my group members during the cleanup.