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Consent Form for Minors Aged 15 to 17 Years Oklahoma Adopt-A-Highway Program

The Oklahoma Department of Transportation's Adopt-A-Highway program is a part of an effort to make our roadways litter-free.  The program is voluntary, designed for non-profit organizations who desire to participate in their community.  Each volunteer group assumes the responsibility for an assigned section of highway and agrees to remove litter a minimum of four times a year, for a two year period.  Actual work sessions will be scheduled and monitored by the adult(s) of the sponsoring group.  Although the Department of Transportation will evaluate any given section of highway for appropriateness for the Adopt-A-Highway program, and will provide ANSI certified safety vests and safety brochures, the Department cannot guarantee the safety of participants.


Section to be completed at Adopt-A-Highway meeting

Date:

Highway To Be Adopted:

Adoption Dates:

 

_______________________________________________________________

Parent / Guardian's Signature

_______________________________________________________________

Minor's Signature

_______________________________________________________________

Minor's Date Of Birth


PARENT ACKNOWLEDGEMENT OF WARNING AND RELEASE

You release and discharge the State of Oklahoma, the Oklahoma Department of Transportation, and their officers, agents and employees, from all claims, demands and causes of action of every kind whatsoever for any damages and/or injuries which may result from your participation, or your minor's participation in the Adopt-A-Highway program and other voluntary activities on or near the highway right-of-way. You further agree to hold harmless the State of Oklahoma, the Oklahoma Department of Transportation, and their officers, agents and employees, from liability for any damages or injuries resulting from any acts or failure to act on your part or your minor's part, during our participation in said voluntary activities on or near the highway right-of-way.  You acknowledge that this consent is valid and effective for twenty-four (24) months.

Any person who has not attended reference training (safety training meeting, watched training video) are not allowed to participate in the Adopt-A-Highway program. Only the volunteers that have signed this release are allowed to attend litter pickups.

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(REVISED 02/2018)

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Last Modified on Feb 09, 2021
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