We agree that work will be performed under and in accordance with the Rhode Island Department of Transportation's Adopt-A-Highway Guidlines and Conditions located here and incorporated herein by reference.

We further agree that if our application is approved, each participating member of our organization, for themselves shall at all times indemnify and save harmless RIDOT and RIDOT employees, agents and officers, from responsibility, damage or liability arising from the exercise of the privileges granted in such applications.

We further agree that this application may be terminated by RIDOT at any time RIDOT determines that, under this program is unsafe or causes a conflict with traffic. The Department reserves the right to revise or discontinue this program at a time.

Enter data on the form found below to submit online or Click here to print a blank form.

Please fill in all required(*) fields.

*First Name                    *Last Name                    MI

*Organization

*Address

*City                                State       *Zip Code        RI AL AK AS AZ AR CA CO CT DE DC FM FL GA HI ID IL IN IA KS KY LA ME MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA SC SD TN TX UT VT VA WA WV WI WY

*Home Phone #                        Work Phone # (xxx-xxx-xxxx)                          (xxx-xxx-xxxx/ext)

*Email Address

*Name To Appear on Sign (Limit 28 letters/spaces)

The Rhode Island Department of Transportation will work with the adopting group to determine the specific section of roadway to be adopted. Limited access multi-line divided highways, interstates, and areas which lack sufficiently wide right-of-way are prohibited from being adopted. List highway section, in order of preference, which you are interested in adopting including City/Town, road name and route number and termini description.

*Rte. # or Road Name

*Starting Point

*Ending Point

Occasionally we receive calls from reporters or citizens requesting information about groups participating in Adopt-A-Highway. If someone calls about your group, would your like your phone number released?

Yes No

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