Community Cleanup Sign-Up Form
Register to participate and choose your tasks
Are you registering as an individual or a group?
*
Individual
Group
Full Name
*
First Name
Last Name
Group Name (if applicable)
Number of Participants (if group)
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
In which Community will you be participating.
*
Please Select
Coalton
Jackson
Oak Hill
Wellston
Which tasks would you like to help with? (Select all that apply)
*
Laying mulch
Picking up trash
Weeding
Recycling
Other
T-Shirt Size (for $5 donation)
Please Select
Community Group (Please contact me)
Small
Medium
Large
X-Large
2X
3X
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Comments
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