AACS Registration Form

Clean-up Event Registration

Help the Latino Clubs clean up our community! We have entered the Adopt a City Street Program! This is a great opportunity to earn volunteer hours or to give back and help your community!
SW 3rd and S. Walker Ave

We will resume our clean-up events on Saturday, April 12th @12PM, all events will begin at the agency (420 SW 10th St. OKC, OK 73109).
Name*

First NameLast Name
Birthdate*

MonthDayYear
Birthday
Gender
E-mail*
example@example.com
Mobile Number*
Grade*
Occupation/School*
Parent/Guardian(s)
Emergency Contact(s)*
Waiver and Photo Release

By clicking submit, you acknowledge and agree that participation in the Latino Clubs Clean Up Event organized by the Latino Community Development Agency involves inherent risks or other losses, which you voluntarily assume. You release and discharge the Latino Community Development Agency employees, volunteers, and agents from any claims or causes of action arising from your participation. You agree to indemnify and hold harmless the Latino Community Development Agency from any claims, liabilities, damages, or expenses arising from your participation. You consent to receive necessary medical treatment if injured and to comply with all event rules and instructions. You authorize the Latino Community Development Agency to use, reproduce, and publish any photographs or videos of you for promotional purposes without compensation.
Once you click SUBMIT, you will be redirected to the Safety Tips and Release and Waiver of Liability Form provided by Oklahoma City, please have this ready at the time of the event. You can also send it directly to me via email.

Address: 420 SW 10th St. Oklahoma City, OK 73109

Email: lcdaclub@latinoagencyokc.org
Additional Comments
Parent/Guardian Name

First NameLast Name
Parent/Guardian Phone Number
Please enter a valid phone number.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Should be Empty:

Clean-up Event Registration