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2. 
3. Thank you!

   Thank you for your hard work. We appreciate your time, energy, and willingness to help Keep Shady Shores Beautiful! 

5. Contact Information
7. First Name*
8. Last Name*
10. Group Name
11. Number of Volunteers (include yourself)
12. #of Children <18 In Group
13. #of Adults In Group
15. CLEAN UP Address/Location *

    What area did you collect in? 

17. Phone Number*
18. Email Address
20. Collection Results
22. Est Number of Hours
24. Total Number of 33 gallon bags collected: (A)*
26. Weight: total bags collected x 20lbs (A x 20)
28. Estimated weight of other bulky items not bagged (tires, wood, debris): (C)
30. Estimated weight of all litter collected: (B+C)
32. If litter pick up is necessary, check here

    1. katie.klein@shady-shores.com
33. All members of our group reviewed the safety guidelines*
    -- Select One --Yes
35. Before, During and After Pictures

    By submitting photos, participants give the Town of Shady Shores permission to use their voice, image, or likeness as it appears in any photograph, film, or recording in any manner, in all media, in perpetuity to the Town of Shady Shores. 

37. 
    
Leave This Blank:


39. 1. Receive an email copy of this form.
40. Email address

    This field is not part of the form submission.

41. Submit Submit and Print

* indicates a required field