Mission:Clean Stream - Registration

If you would like to volunteer to participate in the Mission: Clean Stream clean up at Riverlands, Cora Island, or Portage des Sioux please complete the registration below.  Thank you so much for your participation.

But first, please click on this WAIVER RELEASE FORM to open it in your browser.  Then please print and complete it.  Each participant must have a completed waiver.  Bring it with you to the event.  This will save a lot of time.  Thanks for your participation!

* Event:  M:CS @Riverlands
 M:CS @Cora Island
 M:CS @Portage des Sioux
* First Name
* Last Name
* Address 1
Address 2
* City
* State
* Zip
* Email
* Phone ( ) -
* Emergency Contact Phone ( ) -
* Emergency Contact Name
* Did you download and print the waiver form?  Yes
  No
Family Member 1 Name
Family Member 1 Age  18 Years or Older
  Less Than 18
Family Member 2 Name
Family Member 2 Age  18 Years or Older
  Less Than 18
Family Member 3 Name
Family Member 3 Age  18 Years or Older
  Less Than 18
Family Member 4 Name
Family Member 4 Age  18 Years or Older
  Less Than 18
Family Member 5 Name
Family Member 5 Age  18 Years or Older
  Less Than 18
I am a Member of a Group  Yes
  No
Name of My Group
* Captcha: Please type the letters as they appear in the box below.
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