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First Name*:
Last Name*:
Address:
City:
State:
ZIP
Phone (example: 321-234-5678)*:
E-mail*:
I/we would like to participate as:
Volunteer-On Water
Volunteer-On Land
In-kind Donor
Events Sponsor
Performer/Band
I/we will provide own canoe/boat/kayak:
yes
no
I have a canoe partner:
Yes
No
Partner's name:
Please provide information about how your talents/resources
can benefit the cleanup:
Please review your information before submitting:
*required