Earth Week Participant Signup

Registration Form & Waiver for Earth Week Participants.
April 21-27, 2025
Materials can be picked up at 150 Kendall St. S, Battle Creek, MI 49037, the Department of Public Works.

Contact Bessie at beploeg@battlecreekmi.gov or 269-966-3355 x1889 to organize a pickup date/time.
In the greater Battle Creek area we urge all residents, businesses, and institutions to use Earth Week to celebrate the Earth and promote its conservation and protection.

Individuals or groups can sign up for a section of Linear Path to clean up at your own pace and on your own schedule during the week. The City will provide supplies for volunteers and pick up the collected trash at the end of the week.
- Please leave bagged debris near the Linear Path or parking area off the path, but visible to our Field Service Crews.
- Please wear appropriate shoes and clothes that can get dirty - remember rain gear if the weather forecasts a chance of rain.
- We will supply gloves, trash grabbers, trash bags, and buckets.
  - Please return all of these items to your crew leader or to the Department of Public Works when you are done.
Find more information at bcwater.org/events.
Volunteer Information
Registrant Information*
Group Name or Affiliation*
Scout Troop #, Church, Company, School (NHS), etc.
I am signing up a group and will be the contact person/crew leader for that group.*

YesNo
Group Member(s)*
Volunteer Availability
Is there a specific location in Battle Creek you would like to volunteer in? Site numbers can be found at bcwater.org/events.
Local Park, Linear Path, Near water, In the woods...
Please select all that apply.
Please select all that apply.*
Emergency Contact Information
Emergency Contact: *
Relationship*
Emergency Contact:*

Area CodePhone Number
Add any extra information you feel we should know.
Allergy (Bees or Poison Ivy), Health/Behavioral Condition, Dietary Needs/Restrictions, Activity Restriction:
Please list all that apply.
RELEASE OF CLAIMS WAIVER FORM

I fully understand that by signing this liability disclaimer, I, on behalf of myself and my agents, my group members, heirs and next of kin, assume all risks and hazards incidental to my participation in this activity, including transportation to and from these activities. I do hereby waive, release, absolve, indemnify, and agree to hold harmless, collectively, and individually, the City of Battle Creek, and Calhoun County from any claim arising from sickness, injury or death to me or my property except if caused by their gross negligence or willful and wanton misconduct.

I agree that if the City of Battle Creek, and Calhoun County are sued by anyone else because of claimed conduct of myself, I will indemnify the City of Battle Creek, the City of Springfield, and Calhoun County for all damages and costs, including attorney’s fees.
Confirmation

I HAVE READ AND UNDERSTAND THE AGREEMENT.

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature of Registrant (Signature from Parent or Guardian if under 18).*

Clear
Date*

MonthDayYear
Any questions or comments about your registration:
We thank you for all you do!

bcwater.org
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Registration Form & Waiver for Earth Week Participants.

April 21-27, 2025

Materials can be picked up at 150 Kendall St. S, Battle Creek, MI 49037, the Department of Public Works.

Volunteer Availability

Add any extra information you feel we should know.

RELEASE OF CLAIMS WAIVER FORM

We thank you for all you do!