Bag the Butts Registration
Thank you for being part of the solution for our community! Please sign a TEAM (up to 10 members) up below.
TEAM Captains will be contacted by April 30th with a day/time to pick up the "Bag the Butts" park clean-up tool-kit.
Name of your TEAM?
TEAM Captain's Name (First & Last Name)
TEAM Captain Phone Number
TEAM Captain Email
Your preferred first choice park/city to "bag the butts"?
Your preferred second choice park/city to "bag the butts"?
Please list names of TEAM members and their t-shirt sizes*. *T-shirts are available while supplies last; please denote adult or youth size.
Are you participating in the "Nebraska Earth Day Passport - Check in Challenge"
How did you hear about the event?
Send me a copy of my responses.
Never submit passwords through Google Forms.
This form was created inside of CHI Health Midlands.