Adopt-A-Street Registration Form

Great American Cleanup of Broward County 2008

Adopt-A-Street Group Information

Adopt-A-Street Group Name:    

Group Leader/Contact:    

Daytime Phone (eg; 111-111-1111):    

E-mail (eg; user_name@your_domain.com):  

Delivery Address: (For event supplies and giveaways)  

Cleanup Event Information

Event Date (eg; MM/DD/YYYY):    

Approx. Number of Volunteers:  

Event Start Time (eg; 00:00am/pm):    

Street Adopted:  

Special Notes/Supply Needs:  

To count towards the Great American Cleanup of Broward County, your group must clean your designated street during March, April or May. Some groups even choose to do a cleanup once a month during this national spring cleaning event!

An Event Completion Form must be filled out and returned to the Adopt-A-Street office by June 6, 2008 to be eligible for any prizes and giveaways.

Remember to go over the safety information prior to any cleanup and have members sign the City's Release and Waiver Form. The safety guidelines and waiver forms are located in the Group Leader's Manual.

   Check here if you have read this statement.