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.
Email address *
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?
Submit
Never submit passwords through Google Forms.
reCAPTCHA
This form was created inside of CHI Health Midlands. Report Abuse