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2. Community Cleanup Registration Form
4. Thank you for registering a cleanup with Keep Norfolk Beautiful! When registration is received, staff will reach out via e-mail with online training information.
6. Group Leader First Name*
7. Group Leader Last Name*
8. Phone Number
10. E-mail Address*
11. Co-leader E-mail Address
13. Cleanup Location*

    List your cleanup location or let us know if you would like us to identify a location for your group. 

14. Expected Number of Volunteers*
16. Cleanup Date and Start Time*
    Cleanup Date and Start Time

    Cleanup Date and Start Time
18. Comments
    Questions or concerns about tools, pick up, drop off, or anything else regarding your cleanup.
20. Signature*

    I confirm that I am at least 18 years of age, and I agree to lead a volunteer cleanup in accordance with guidelines and safety procedures set by Keep Norfolk Beautiful and the City of Norfolk. 

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22. 1. Receive an email copy of this form.
23. Email address

    This field is not part of the form submission.

24. Submit Submit and Print

* indicates a required field