2017 Rockbridge Community Clean Up Registration Form (Mar 25 - Apr 2, 2017)
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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