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King County Road Services - Adopt–A–Road Clean-Up Results Form

This form is used by the Adopt-A-Road program to track volunteer participation and perform program audits. Please remember to report this information after each cleanup.

Group number  Find your group number.
Clean-up date (required)

Group leader's name
Group leader's contact phone number
Name of organization (required)
Name of road adopted (required)
Number of volunteers that participated 
Number of hours the cleanup lasted 
Approximate number of bags of trash collected 
Did you participate in the recycling program? .    If yes, we gathered  bags of recycling
Were there any unusual incidents or injuries during the cleanup?
Other comments

If you have questions, need help filling out this for or to comment, please call 206-296-3807.