2012 Riverbank Clean-Up Registration

Please fill out the form below to register for the Riverbank Clean-Up. You will receive a phone call at a later date to arrange the details for your group.

We will do our best to accommodate all location requests, but we cannot guarantee that a specific location will be available. If you have no preference, we will work with you to select a location that works best for your group.

If you do not receive a confirmation email shortly after your submission, your registration may not have been received. If you do not receive an email, please contact Beth at 607-778-2375.

Group Information

Please give us more information about your group or organization.

Name of Group/Organization: *

Expected number of volunteers: *

We have participated in past Riverbank Clean-Ups: *

Preferred Location: *

Please give specific location (i.e. Behind Sesame Street Gas Station) or general area (i.e. Village of XYZ) and indicate if you have cleaned there in the past. If you have no preference, please state that here.

Stream Captain's Contact Information

You must designate a captain who is in charge of your group. If you are an individual, please fill out your contact information and we will pair you with another group. Please leave information where you can be readily reached. Information will not be used for any purpose other than the Riverbank Clean-Up.

First Name: *

Last Name: *

Phone Number: *

Email: *

Additional Information/Comments:

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