2019 Little River Clean-up Pre-Registration
Event Date: Saturday, August 24, 2019
Event Time: 8 a.m. to noon
NOTE: THIS FORM IS FOR ADULT PARTICIPANTS ONLY.
If you have a minor that would like to volunteer, please email tmorris@floydcova.org for a minor registration form. Both parents must sign the minor registration form.
Participant Name *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Address *
Your answer
Phone Number *
Your answer
Email *
Your answer
Name of Emergency Contact *
Your answer
Phone Number of Emergency Contact *
Your answer
Preferred Clean Up Area: *
Required
Do you have a life jacket you can bring? *
Will you be bringing your own canoe/kayak? *
Are you affiliated with a group or club participating at the event? *
Required
If you answered "Yes" to the previous question, please list the group or club.
Your answer
How did you hear about this event? *
Your answer
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