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2022 Pearl River Clean Sweep Registration Form
September 17, 2022

Parents/Guardians must register for participants of minor age (under age 18 at the time of registration). Parents/Guardians may use this form to register all family members. In the comments section, please list the names of all participating family members.

* Indicates required field

NAME *

First

Last

EMAIL *

Your Phone Number *

Emergency Contact Person and Phone Number *

VOLUNTEER OPENINGS *

WATER BASED CLEANUP CREW LAND BASED CLEANUP CREW SITE LEADER

PLEASE CHOOSE YOUR DESIRED CLEANUP LOCATION/DATE
(for cleanup location information, click here)

CHOOSE CLEANUP LOCATION *

If you'd like to suggest a new cleanup location, please add location below: *

If you are participating as a member of Scouts or other community service organization, please list organization name and contact person: *

WAIVER & RELEASE OF LIABILITY (please click to view or to print) *

I have read the waiver I accept the terms of the waiver

Acknowlegment and Assumption of Risk Relating to Coronavirus/COVID-19 *

I acknowledge the contagious nature of COVID-19 and acknowledge the risk that my child, myself, or my family may be exposed to or infected by COVID-19 by participating in this event. I assume all risks related to myself, my child and my family due to COVID-19 and agree to waive and hold harmless Pearl Riverkeeper from any liability thereon.

Questions or Comments *

Submit

2022 Pearl River Clean Sweep Registration Form
September 17, 2022

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Pearl Riverkeeper is a licensed member of the Waterkeeper Alliance, the largest and fastest growing nonprofit solely focused on clean water.

2022 Pearl River Clean Sweep Registration Form​September 17, 2022

Stay Informed! Sign up to receive the latest news.

Pearl Riverkeeper is a licensed member of the Waterkeeper Alliance, the largest and fastest growing nonprofit solely focused on clean water.

2022 Pearl River Clean Sweep Registration Form
September 17, 2022