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Clinton County Waste Management Volunteer Registration
*
Means Field Is Required
Complete the information below and click Submit.
Shift station assignments, along with additional information will be mailed approximately one week before event.
I Can Volunteer at the Following Events:
First Name
*
Last Name
*
Mailing Street Address
*
Apt / Suite / Unit Number
State
*
City
*
Postal Code
*
Phone
Email
*
Preferred Station
Please List Other Times You Would Be Available:
Comments Or Special Considerations:
Will you be 17 years of age or older at the time of the event?
*
Yes
No
Supervisor Acknowledgement
*
By checking this box I understand that I must be accompanied by an adult supervisor in order to participate in this event.
Supervisor Name
*
Supervisor Phone
*
Release Form
By indicating Yes below, you are electronically signing and verifying that you have read and agree to the conditions and instructions contained in the Liability Release form.
Download Liability Release Form
Acknowledgement
Yes, I have Read the Release Form and Agree (View Liability Release Form to Enable)
Receive an Email Copy of this Form
Submit Registration
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