Adopt-a-Road | York Region

If you have not already selected a road segment to adopt, please select a location on the Adopt-a-Road map prior to filling out this form.

Visit york.ca/AdoptARoad to learn more.

The personal information submitted in this form is collected under the authority of section 11 of the Municipal Act, 2001 S.O. 2001, c.25 and will be used for the sole purpose of contacting you regarding your application for the York Region Adopt-a-Road program. If you have questions about the collection, use, and disclosure, of your personal information by York Region please contact [email protected]

Organization Name

Contact Name

Phone Number

Email

Road Cleanup Date Preference

Alternate Road Cleanup Date

Location

SegmentID