NYC DEP

Name * First Last
Phone Number * ### - ### - ####
Email *

By signing up to Adopt-a-Catch Basin you agree to being contacted by NYC DEP.

Visit NYC.gov Privacy Policy for more information.
Location of the catch basin you'd like to adopt: *

We do not guarantee you will be assigned the exact basin requested
Would you like to receive a Catch Basin Toolkit?
The toolkit includes: reflective safety vest, garbage bags, recycling bags, canvas gloves, trash grabber, and a rake *
Yes, I would like a toolkit No, I will use my own supplies
Do you agree to clearing your catch basin at least once per month for a full year? *
Yes
Do you agree to periodically report your catch basin clearing activities and findings using our online reporting form? *
Yes
Volunteer Release and Waiver Form

Before participating in the Adopt-a-Catch Basin Program, all participants are required to sign the Volunteer Release and Waiver Form. Do you acknowledge this requirement and agree to sign the form upon acceptance into the program? *
I acknowledge this requirement and agree to sign the form upon acceptance into the program.
Do Not Fill This Out

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