4th of July 2009!

Pollution Prevention & Beach Cleanup

Get involved to help prevent ocean & beach pollution.

Fill out the form below to register for a cleanup.

Fields marked in red are required.

Your Information

Your Name:

Company/organization:

Address:

City:

State, ZIP:,

Country:

Phone:

Email:

Cleanup Information

Number in your group: (numbers only, approximations are OK.)

Select a cleanup:

Special Cleanups Only

Select a location:

Date requested :

Other Information & Special Notes

Will there be participants under age 18?

Have you participated in our cleanups in the past?

Are you a member of one or more of the Coalition's organizations?

Surfrider Foundation
Save Our Shores
Pack Your Trash
Ecology Action

Special Notes :

Verification

Please type in the verification word in the box below.

Comfortable clothes. Please check the weather forcast and dress appropriately. We recommend dressing in layers so you can cool off if you get too hot. Sunglasses are recommended on sunny days.
Sturdy shoes that you don't mind getting a little wet and sandy.
Liability waivers. Members over 18 years of age can sign waivers when they arrive. Or, to save time, they can download the waiver below and bring it with them.
NOTE: If you have members of your group who are under 18 years of age, they will need to have a liability waiver signed by their parent or legal guardian.
Download a liability waiver here (pdf).

Emily Glanville
SAVE OUR SHORES
345 Lake Avenue, Suite A Santa
Cruz, CA 95062
(831) 462-5660 ext 5#
Fax (831) 462-6070