2018 Rockbridge Area Community Clean Up Registration Form
Name of group, family, individual, or Litter Challenge team name *
Your answer
Planned Date *
MM
/
DD
/
YYYY
Approximate number of participants *
Your answer
Contact person *
Your answer
Email for contact person *
Your answer
Phone for contact person *
Your answer
Would you like to enter the Litter Challenge? *
Describe your project *
Required
Please describe your clean up location or what kind of location you would like to have recommended (road, street, trail, river, etc). *
Your answer
Do you have orange safety vests from last year, or your own? *
If you need vests, about how many will you need?
Your answer
Questions or comments?
Your answer
We thank you!
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