KEEP CHARLOTTE BEAUTIFUL ADOPT-A-SHORE PROGRAM
RELEASE FORM


I or we ______________________________,a member of ___________________________, have read
and understand the terms and conditions contained in the Keep Charlotte Beautiful, Inc. Adopt-A-Shore
Agreement and the Roadside Safety Recommendations prior to taking part in litter removal in the County
rights-of-way, and I hereby agree to follow and conduct myself according to all the terms and conditions of
the Keep Charlotte Beautiful, Inc. Adopt-A-Shore Agreement and the Roadside Safety
Recommendations.  

I do hereby release and discharge Keep Charlotte Beautiful, Inc. and the County, and all of Keep
Charlotte Beautiful’s officers, agents, and employees from all liabilities, claims, demands, and causes of
action of every kind whatsoever for any damages and or injuries arising from any cause whatsoever which
may result directly or indirectly from my participation in the Keep Charlotte Beautiful, Inc. Adopt-A-Shore
program.

I further agree to hold harmless Keep Charlotte Beautiful, Inc. and its officers, agents, and employees
from liability for any damages or injuries resulting from any acts or failure to act on my part during my
participation in any Adopt-A-Shore activities on or near Charlotte County rights-of-way.

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