Link to Kitsap County's Mission Statement
Public Works - Solid Waste Division
614 Division Street, Port Orchard, WA  MS-27
Phone: (360)337-5777 * Fax: (360)337-4867
 

    

 

 

 

 

 

 

360-337-5777
REPORT ILLEGAL DUMPING

 

360 337 5285
REPORT TRASH BURNING

 

 

 

Adopt-A-Road Program
Application Form

We've made it easy to apply!  Fill out the form below and click on submit.  The electronic form will be sent to the Adopt-A-Road Coordinator.  We will contact you with scheduling information and legal documents as follows:

  • Written Agreement - We will ask you to complete an Adopt-A-Road Agreement

  • Safety Orientation - We will provide a brief safety orientation to make certain you are aware of the risks and responsibilities to be assumed by Adopt-A-Road volunteers

  • Liability Release - Each adult volunteer, or parent of minor children, must sign a liability release

  • Medical Coverage - Kitsap County provides excess accident medical coverage, and excess volunteer liability insurance coverage while performing volunteer duties.  Coverage specifics are available upon request.


Name:   

Organization or Group: 

Address:     

City, State:  

Daytime Phone: 

Evening Phone:  

Email Address:  

How many volunteers are 15-17 years old? 

How many volunteers are 18 or older?        

What road would you like to adopt?  Please give the complete road name and the cross roads marking the start and end points.  Roads are assigned on a first-come, first-serve basis after a safety review.

First Choice Road Name:
             From:
             To:   
Second Road Name: 
            From:
            To:    
Third Road Name: 
            From:
            To:    
What trail, beach or park would you like to adopt?
 Name of beach, trail or park: 
  Location:
   


Staff Contact:  Adopt-A-Road Coordinator

Kitsap County Public Works
Kitsap1: 360.337.5777
solidwaste@co.kitsap.wa.us

Updated:  December 11, 2014

 

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