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Community Clean-up Registration Form
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* Indicates required question
Event Organizer Contact Name
*
Your answer
Phone Number
Your answer
Email
*
Your answer
Area of Interest
Park
Roadside
Community Garden
Local Town/ Village Halls
Schools
Cemeteries
Public Spaces
Library
Historic Properties
Other:
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Organization Name
Your answer
Event Title
Your answer
Facebook or Website for Event (list any applicable link below)
Your answer
Municipality (in which event will take place)
Choose
Avon
Caledonia
Conesus
Geneseo
Groveland
Leicester
Lima
Livonia
Mount Morris
North Dansville
Nunda
Ossian
Portage
Sparta
Springwater
West Sparta
York
Date(s) of Event
MM
/
DD
/
YYYY
Time of Event
Choose
9 am to 10 am
10 am to 11 am
11 am to 12 pm
12 pm - 1 pm
1 pm to 2 pm
Type of Event
Park Clean Up
Public Space/ Trail Clean Up
Other:
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Short Description of Clean-Up Activity
Your answer
Address or Meet-up location
Your answer
How many volunteers do you have?
Fewer than 5
5 to 10
10 to 20
More than 20
Clear selection
Do you need more volunteers?
Yes
No
Are drop-in volunteers welcome?
Yes
No
Is the activity safe for children to participate?
Yes
No
Please list any special equipment that volunteers should bring for themselves:
Gloves
Safety Glasses
Trash Bags
Rake
Shovel
Wheelbarrow
Other:
Additional Needs/ Comments
Your answer
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