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CLEAN Bingo 2020

2. CLEAN Bingo
   <br>CLEAN stands for Community Love through Environmental Action in Norfolk. Fill out this form to download the CLEAN Bingo packet. Thank you for helping us keep Norfolk CLEAN!

   
   CLEAN stands for Community Love through Environmental Action in Norfolk. Fill out this form to download the CLEAN Bingo packet. Thank you for helping us keep Norfolk CLEAN!

4. First Name*

5. Last Name*

6. Email*

8. Conditions for Volunteering
   <br>As a volunteer for Keep Norfolk Beautiful... <br>- I, and my participants, will wear a face mask. <br>- I understand that volunteers under age 18 must be accompanied by a parent or legal guardian. <br>- I am responsible for the health and safety of any youth brought with me. <br>- I will practice social distancing, of 6-10 feet, with anyone outside of my household. <br>- I will not participate in a Keep Norfolk Beautiful event if I have been exposed to someone who tested positive for COVID-19, if I tested positive for COVID-19, or have any cold or flu like symptoms in the last 14 days. <br>- I will notify KNB immediately if, within 14 days of the event, I test positive for COVID-19. <br>- I understand that Keep Norfolk Beautiful has the right to not allow me to participate if I, or someone I am with, do not, or cannot, adhere to the safety guidelines or pose a risk to myself or others. <br>- The CLEAN Bingo packet will be available to download and print once this form is submitted. <br>- KNB can provide copies of paperwork, as well as cleanup supplies like trash bags and plastic gloves. Email knb@norfolk.gov to schedule a time for supply pickup or when you are ready to turn in your Bingo form.

   
   As a volunteer for Keep Norfolk Beautiful...
   - I, and my participants, will wear a face mask.
   - I understand that volunteers under age 18 must be accompanied by a parent or legal guardian.
   - I am responsible for the health and safety of any youth brought with me.
   - I will practice social distancing, of 6-10 feet, with anyone outside of my household.
   - I will not participate in a Keep Norfolk Beautiful event if I have been exposed to someone who tested positive for COVID-19, if I tested positive for COVID-19, or have any cold or flu like symptoms in the last 14 days.
   - I will notify KNB immediately if, within 14 days of the event, I test positive for COVID-19.
   - I understand that Keep Norfolk Beautiful has the right to not allow me to participate if I, or someone I am with, do not, or cannot, adhere to the safety guidelines or pose a risk to myself or others.
   - The CLEAN Bingo packet will be available to download and print once this form is submitted.
   - KNB can provide copies of paperwork, as well as cleanup supplies like trash bags and plastic gloves. Email knb@norfolk.gov to schedule a time for supply pickup or when you are ready to turn in your Bingo form.

10. I am 18 years of age or older*

    Must be age 18 or older to register

    1. Yes
11. Safety Guidelines
    KNB Safety Guidelines

    All volunteers must read, or be read, the safety guidelines to participate in a KNB activity.

12. Safety Guidelines Acknowledgement

    I have received the Safety Guidelines and will read and made other participants aware of these guidelines prior to engaging in a KNB activity.

    1. Yes
    2. No
14. Signature*

    I have read and agree to adhere the Conditions for Volunteering and the Safety Guidelines.

15. Date*

Leave This Blank:


17. 1. Receive an email copy of this form.
18. Email address

    This field is not part of the form submission.

19. Submit

* indicates a required field