Adopt-A-Block Application Form

This letter will serve as a commitment to adopt a minimum of 2 District of Columbia streets or blocks for litter removal on an interested block.

Group or organization details
Contact details #1
Contact details #2
Clean Up Details
Signage Details
Agreement Details

The Group commits to: Conduct weekly gutter sweeping on all streets in the area. Perform community clean-ups in strict accordance with Adopt-A-Block safety guidelines at least four. Designate a leader who will represent the Group and who will register and brief the participants prior. Select volunteers who are at least 12 years of age. Adult supervision must be provided for youth, ages 12—18. Volunteers under the age of 12 must have strict adult supervision. The OCC will: Install Adopt-A-Block signs within the adopted blocks, which identify the Group. Provide an annual safety meeting.

It is understood that the members of the Group participating in the clean-up are providing volunteer services to the Group and not to the OCC or the Government of the District of Columbia. Either party may terminate this commitment for any reason upon receipt of a 30-day written notice.

This Letter of Intent is non-transferable and non-assignable. This Letter is not intended to create any legally enforceable rights against the Group, its members, the Office of the Clean City, or the Government of the District of Columbia, nor any legally enforceable rights in favor of any person not a party to this Letter of Intent.

I certify that I have read the information contained in this document and that I possess the authority to execute this document on behalf of my Group.

I agree and accept the above terms set forth by the Office of the Clean City.
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