2023 Clean Sweep Volunteer Signup Form

Choose your clean up area*
Are you registering a business or group?*
- Yes
- No
Name of business/group*
Are you cleaning up as part of the Adopt-A-Street program?*
- Yes
- No
How many people will you be cleaning up with?*
What supplies do you want?*
check all that apply
- I want gloves provided for my group
- I want trash bags provided for my group
Volunteer Details
Name*

First

Last
Email*
Phone Number
Address*

Street Address

Address Line 2

City

State

ZIP Code
Waiver of Responsibility*
For any illness, injury, property damage, or loss suffered or sustained by me which is in any way associated with my participation in, travel to and from, or other activities associated with the Clean Sweep and or The 712 Initiative, I do hereby, for myself, my heirs, and my administrators and executors, forever waive, release and discharge any and all rights and claims for expenses, damages, or other losses which I may have or which may hereafter accrue, against The 712 Initiative, their sponsors, officers, directors, employees, agents, successors, and assigns.

Checking 'YES' below is representative of my signature and states that I have read and completely understand the Waiver of Responsibility.
- YES, I have read & understand the Waiver of Responsibilities
- Yes, I would like to receive updates from The 712 Initiative
- Yes, I would like to receive information about other volunteer opportunities

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