Pre-Registration & Supply Request Form
Supplies are available on a first-come first-serve basis
Please choose type of event
Please Select
Adopt-A-Road
Community Cleanup/ Great American Cleanup
Coastal Cleanup/ Waterway Cleanup
One-Time Cleanup
Name
First Name
Last Name
Organization/Community/Group
Contact Phone Number
Please enter a valid phone number.
Email
example@example.com
Location of Event
Event Date & Time
Estimated number of Volunteers
Dumpster Request
Yes
No
Purpose for Dumpster
All Dumpsters requests must be submitted in writing for review and approval no later than 2 weeks prior the requested cleanup date. Please contact KPCB directly to acquire the Dumpster Request & Roll-Off Agreement and rules pertaining to dumpster requests.
Supply Request
All Vests, Litter Grabbers, Tools and remaining cleanup supplies must be returned to the KPCB office within a week upon cleanup completion.
Cleanup Supplies Requested
Other Supplies (i.e. litter grabbers, hand sanitizer, kayaks, volunteer signs, etc.)
T-Shirt & Bok-Tower Ticket Request
Only one Bok Tower Pass & T-Shirt per volunteer (as supplies last)
Bok Tower Passes
Youth Shirts
Small
Medium
Large
X-Large
2X-Large
3X-Large
Submit
Should be Empty: