Registration Form  
 
 
  Name of Individual/Group/Organization  
  (As you wish it to appear in thank-you advertisements)  
 
 
  Contact Name:  
       
  Address:    
       
  Postal Code:    
       
  Phone #:      
       
  Fax #:      
       
  E-Mail Address:    
 
  Have you participated in previous Spring Up to Clean Up campaigns?  
     
  Clean-Up Location:  
     
  Date and Time of Clean-Up:  
 
  Details:  
   
   
   
 
  Number of Volunteers:   Pairs of Latex Gloves, if required:    
  Adults (18+):   Large:   GARBAGE ALERT! Help reduce waste by using leather or cloth work gloves instead of requesting latex gloves. Versatile work gloves are stronger than latex and can be used over and over. If you do decide to use the latex gloves, consider using a glove only on the hand picking up the litter.  
  Youth (10-17):   Medium:    
  Children (under 10):   Small:    
   
  Spring Up Garbage Bags Required:    
       
  Recycling Bags Required:      
   
  Landfill Pass(es) Required:        
  (Smaller clean-ups may place Spring Up garbage bags out for      
  curbside pick-up on regular pick-up day)      
 
  PLEASE NOTE: Spring Up to Clean Up kits are to be picked up from the EcoSuperior office at 212 E. Miles St. Monday to  
  Friday between 8:30am and 4:30pm. We will notify you when your kit is ready for pick-up.  
 
  Once you have completed this form, please click the SUBMIT button. We will send you a confirmation of your registration.  
  If you have not heard back from us within one week, please call Karen at 624-2148.