Rallying Point

Where is the team meeting to start the event?

Nova Scotia

County Select Your County.. Annapolis Antigonish Cape Breton Colchester Cumberlan Digby East Hants Guysborough Halifax West Hants Inverness Kings Lunenburg Pictou Queens Richmond Shelburne Victoria Yarmouth

Clean Up

Clean Up Type Select your type of Clean Up Roadside Shoreline Parks and Trails School Other

Do you require supplies for your cleanup? Please Select.. No Yes. Bags & gloves. Yes. Bags, gloves, and safety vests.

Date & Time

When should the Team meet?

AM or PM Select... am pm

How did you Hear about us?

How did you Hear About Us? Select... Facebook Instagram Twitter Waste App Radio Online Search such as Google, Bing, Firefox, etc Word of Mouth We've Done This Before Other

Social Media

Have a social media account where you can share your hard work with others? Please be sure to tag us! #EveryLitterBitHelps #nspickmeup #nsadoptahighway #CleanCanadaTogether

Assumption of Risk Form

Will you be holding your event on a Provincial roadway? Please Select.. No - The below Assumption of Risk Agreement does not apply to my event Yes - I accept the below Assumption of Risk Agreement.

If you do not know if your clean-up is taking place on a provincial roadway, please email litterprograms@coastalaction.org. Clean-ups on 100 Series Highways are not permitted.

I for myself, my heirs, executors, or anyone else who may claim on my behalf, covenant to sue, do hereby waive, release, and discharge, to the fullest extent permissible by law, Coastal Action and the Nova Scotia Department of Public Works, and their employees and agents, or anyone acting on their behalf, for any claims or liability of personal injury, death, damage to property or loss of any kind and however caused, whether arising by reason of the negligence of the Province of Nova Scotia or Coastal Action, or anyone acting on their behalf, or otherwise.

I also acknowledge the risks involved in the Litter Program, which I am being allowed to undertake freely of my own volition, taking place on the above clean-up date and location.

Assumption of Risk Agreement Form: Appendix

• All participants must be 12 years of age or older. Every six participants aged 12-17 require one adult supervisor (18 years or older). A trained individual with a First Aid Kit is to be at the litter clean-up site.
• No litter clean-up is to be performed until every member of the group is wearing a safety vest which is provided by or approved by Public Works. Borrowed supplies must be returned to Public Works or the relevant Waste Management Authority the next business day following the clean-up.
• The litter clean-up operation is to proceed along one side of the adopted highway section at a time and within the limits of this section. All vehicles are to park on side roads or in parking areas off the shoulder of the road. All volunteers must confine their activities to the ditch and off the shoulder except to deposit full bags on the shoulder for later pick-up.
• The group may be responsible for transporting litter bags to an approved landfill or pre-arranged site. Call your local PW base to check if staff are available to pick up the litter bags. During the clean-up, all materials, substances, containers and large animal carcasses not suitable for removal by the members of the group must be marked with a coloured ribbon on a stake or near the shoulder of the road.

Permission

I acknowledge that I have read the Waiver and agree to all terms and conditions within. Note: This waiver must be filled out 2 (two) weeks before the proposed clean-up. Volunteers younger than 18 years of age must have their waiver signed by a parent or legal guardian.

I certify the above statement to be true Select.. Yes No