Report Your Cleanup | Cleanvalley

First Name

Last Name

Team Name (if applicable)

Phone

Street Address

City

Postal / Zip code

Street Address Line 2

Number of participating adults

Number of hours

Date of cleanup

Number of participating children

Number of bags collected

Brief description of cleanup location (street or park name)

Description and approximate quantities of the types of litter you found, i.e. 25 cans, 10 plastic bags, etc.

Additional comments

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