Community Wash Day Form

Registration Form: Community Wash Day

Fill out the form carefully for registration
Name

First NameLast NamePreferred Laundry Detergent
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email
example@example.com
Contact Number
Format: (000) 000-0000.
Requested Number of Loads to Be Washed/Dried
Your signature releases Safe Place Foundation, Inc., volunteers, and participating facilities from all liability, claims, & demands from incidents/accidents that may occur as a result of participating in our program. Thank you for your understanding and support as we strive to serve our community.
Signature
Should be Empty:

Registration Form: Community Wash Day