Adopt a Glen Rock Storm Drain - Adoption Form
A project of the Glen Rock Environmental Commission and Green Team, the Adopt A Storm Drain program brings together the passion and pride of citizen volunteers with the technical savvy of Borough staff to make Glen Rock safer, cleaner, greener and more beautiful. By adopting a storm drain, you will help to beautify the neighborhood, reduce localized flooding, and help stop litter and debris from entering our waterways.
Please verify that you are an adult. Only adults can adopt storm drains and it will be up to those adults to monitor their minors.
I verify that I am 18 years or older.
Phone (if you don't have email):
If you are adopting as a group/club/business, please entire the org's name:
Do you want to remain anonymous or let people know you adopted this drain?
I want to remain anonymous.
I do not want to remain anonymous.
IT'S ADOPTION TIME!
Enter the next question as best you can, by looking at the address of the house/business nearest the storm drain you want to adopt. We will only reach out to you if that storm drain is already adopted (odds are it's not adopted).
Address of the Storm Drain you wish to adopt. The address is based on the house number closest to the storm drain and the street.
Anything else we should know?
HOLD HARMLESS AGREEMENT
In connection with the Borough of Glen Rock’s Adopt A Storm Drain program, we agree to defend, indemnify and hold harmless the Borough of Glen Rock, its agents and administrators from and against any and all claims or actions at law, whether for personal injury, property damage or liability, including any cost of defense incurred by the Borough of Glen Rock, which arise from our actions, those of our agents or employees in the execution of the work and/or duties to be performed during our participation in the Adopt A Storm Drain program.
By checking this box I agree to the Hold Harmless Agreement.
Thanks for stepping up to ADOPT a Storm Drain in Glen Rock! We'll reach out to you in the next 3 days to confirm your adoption.
Meanwhile, don't wait on us. If your storm drain is in need of immediate maintenance, go ahead and start. Instructions can be found here,
REMEMBER: work from the curb side of the drain and stay out of the road. We want you to be safe at all times!
Never submit passwords through Google Forms.
This form was created inside of Laura Occhipinti.