Register for the April 2023 Keep Plainville Beautiful Cleanup! 
Thank you for your interest in participating in our April Keep Plainville Beautiful Cleanup! This year our event will run from April 1-30. We will have dates to pick up supplies and will end with a Pizza Party thanks to the generosity of our local businesses. Details of dates and locations for supply pickup and litter disposal will be emailed to all participants. If you have any questions, please email us at keepplainvillebeautiful@gmail.com.
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Email *
Name *
If registering as a Business or Community Group, enter your organization's name.
Phone Number *
Number of participants. *
If you need trash bags how many?
If you need work gloves how many pairs? While supplies last.
If you need grabbers how many? (Must be returned) While supplies last.
If you need safety vests how many? (Must be returned) No longer available.
If you would like tee shirts indicate quantities and sizes as such: Adults extra-extra-large (XXL), extra-large (XL), large (L), medium (M), Children's large (CL). While supplies last. Example: 2 M, 1 CL
How many will be attending the Pizza Party? The Pizza Party will be held on April 30 at the Town Hall Community Room at 12 pm. *
Please select the locations you would like to clean up.   *
Required

I, a participant in the volunteer activities sponsored by Keep Plainville Beautiful, agree to follow all cleanup instructions as stipulated by local cleanup organizers. I understand the work that I and others in my party have volunteered to do and hereby state that I am qualified and physically capable of accomplishing the work and activities for which I have volunteered. I understand that I may be collecting various types of debris, including broken glass, sharp objects, and other materials that may cause injury if handled improperly. Do not attempt to pick up hypodermic needles or other drug paraphernalia. Call the Fire Dept at 508-695-5252. All materials of unknown contents, heavy weight, or questionable safety (medical debris, chemical containers) will be left in place untouched, the location noted, and the cleanup coordinator informed. Keep Plainville Beautiful has no responsibility for any injuries that occur during the cleanup.

By registering to participate in this event, I confirm that I have read and agreed to the following liability waiver: I hereby release Keep Plainville Beautiful and its respective directors, officers, contractors, employees, and agents from any and all liability, claims, loss, damage, expenses and/or injuries, whether to person or to property, which may result from my participation (as well as others I supervise) in this volunteer activity. I further agree to indemnify, defend, and hold harmless Keep Plainville Beautiful and its respective directors, officers, contractors, employees, and agents from any and all liability, claims, loss, damage, expenses and/or injuries, whether to person or to property, which may result from my participation (as well as others I supervise) in this volunteer activity. I acknowledge that I cannot make any claims against Keep Plainville Beautiful or its respective directors, officers, contractors, employees, or agents for any injury, loss, or damage to person (including bodily injury or death) or property suffered while participating in this volunteer event.

Releasor acknowledges that novel coronavirus (“Covid-19”) infections have been confirmed throughout the United States as well as within the county and region in which the activities listed above will occur. Releasor further acknowledges that participating in such activities comes with the inherent risk of contracting Covid-19 from Keep Plainville Beautiful staff, other participants, the general public, or otherwise. Releasor agrees to adhere to all Covid-19 related protocols and restrictions in place as promulgated by the Commonwealth of Massachusetts and local government policies.

PHOTOGRAPHS – I hereby provide consent that photographs of me taken at this event can be used by Keep Plainville Beautiful and its affiliates in publications, presentations, social media posts, websites, and sent to media outlets. In addition, I affirm that I hereby transfer the rights to any of the photos I post on Keep Plainville Beautiful social media sites to Keep Plainville Beautiful.

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A copy of your responses will be emailed to the address you provided.
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