Adopt-a-Stop Sign-Up Form

Step 1: Adopt-a-Stop Responsibilities

Before you can sign-up you must agree to the following:

1) Adopt one (or more) ART bus stop(s) for one year. Only bus stops that solely serve ART can be adopted. View a list of adoptable stops.

2) Regularly maintain (at least once a week) the adopted bus stop by being responsible for trash pick-up. Arlington Transit will provide a trash receptacle for the bus stop upon request of the participant. The participant is expected to empty the trash and replace the trash bag with a new one at least once a week. Participant is also expected to pick-up litter around and/or near the bus stop. Participant will need to provide their own trash bags for picking-up the trash.

3) When it snows, clear a sidewalk path from the nearest curb ramp to the bus stop and a path from the bus stop to the road. Snow should be removed within the timeframe outlined by Arlington County’s snow removal ordinance.

4) Report vandalism, disturbances, safety issues, and items left at the bus stop to Arlington Transit. Suspicious packages, drug paraphernalia, and illegal looking items should not be handled -- report suspicious items immediately to law enforcement at 703-558-2222.

5) Participants must be 18 years or older, unless they are part of a group. If a group of participants wants to adopt-a-stop the group leader must be at least 18 years of age and a group form must be filled out.

Individuals or groups can adopt a bus stop for a commitment of a year. The adopter pledges to keep their bus stop clean, performing tasks on a weekly basis. For questions or more information please call 703-228-3545.

The following conditions shall apply:

  • Group leaders must obtain written permission from the parent or legal guardian of children less than 18 years of age, granting permission to participate in the Adopt-A-Stop Program. Individuals or groups with members under 15 years of age must be supervised by adults 18 years or older. Groups must fill out a group form.
  • All volunteers must sign a Release of Liability, Waiver of Claims and Indemnity Agreement and submit them to the Transit Bureau before participation in any clean-up.
  • No additions or changes to any County property may be made by the Adopter without a written request and approval by the Transit Bureau. All requests should be sent to the Adopt-a-Stop by email or by calling 703-228-3545.
  • Any property that is damaged must be returned to its original condition.
  • No signs of any kind shall be removed.
  • The Adopter accepts full responsibility for all damages and injuries, which may result from their actions. Arlington County will not be responsible for any claims of property loss or personal injury.
  • This is not intended to create any rights in any third party or any person doing work for or on behalf of the Adopter.
  • The contact shall report any injuries incurred by any volunteer during cleanup activities to the County Adopt-A-Stop coordinator within two (2) working days of the occurrence. Notification should include:
    • The name of the injured person or persons
    • The nature of the injury
    • The time and date of the injury
    • Details about how the injury occurred
    • Which hospital or clinic the injured person was admitted to or attended, if any
  • The Adopter or Arlington County may terminate this commitment for any reason upon 30-day written notice.

Step 2: Assumption of Risk

ASSUMPTION OF RISK

I am aware that engaging in an Adopt-A-Stop activity may involve certain risks, dangers and hazards, including, but not limited to, picking up dangerous debris and collision with passing traffic. I agree to wear a safety vest while participating to minimize any such risks and I freely accept, and fully understand and assume all risks and dangers that may arise out of or result from my participation in the Adopt-a-Stop program.

RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT

By participating in the Adopt-A-Stop program I hereby agree as follows:

1. TO WAIVE any and all claims that I have or may in the future have against Arlington County (including its elected and appointed officials, agents and employees, hereafter known as “the County”) resulting from my participation in the program.

2. TO RELEASE the County from any and all liability for any loss, damage, injury or expense that I may suffer or that my next of kin may suffer as a result of participating in the Adopt-A-Stop program due to any cause whatsoever.

3. TO HOLD HARMLESS AND INDEMNIFY the County from any and all liability for any property damage or personal injury to any third party, resulting from my participation in the program.

4. This Release shall be effective and binding upon my heirs, next of kin, executors, administrators and assigns, in the event of my death. I have read this Release prior to signing it and I understand its effect. I am aware that by signing this Release I am waiving certain legal rights which I or my heirs, next of kin, executors, administrators and assigns may otherwise have had against the County.

5. If you are a group, please fill out the Group Release Form prior to conducting the clean up and send to the Transit Bureau.

Step 3: Submit Required Information


ART Adopt-a-Stop Sign-Up Form

Items in bold are required.

I have read and agree to the Adopt-A-Stop Program tasks, responsibilities and conditions.

I have read the foregoing Release of Liability, Waiver of Claim and Indemnity Agreement and agree to the terms of participation.

Contact person: 

Organization: 

Street address: 

Street address 2: 

City:

State:

Zipcode:

Phone number:

Alternate phone:

Email:

ID number for bus stop you wish to adopt (See list; ID numbers are under each stop location):

Bus stop, second choice:

Name of person or organization as it should appear on recognition plaque:

Comments:

Leave this field empty