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Clemmons Cleanup 2020

  1. Do you need Crosby Scholar Hours?

  2. Date must be a minimum of 48 hours from when form is submitted

  3. • Do you have participants under the age of 13? *

  4. Ex: 3715 Clemmons Road - please leave on bench beside front door

  5. Number of Shirts and Sizes (only for people participating in the cleanup)

  6. By submitting this form, I understand that as a participant in a Village event, I recognize that there is a risk of harm, or injury exists and agree to hold harmless the Village. I also agree to the following rules and guidelines listed in the Safety Bulletin below..*

  7. Safety Bulletin

    Village of Clemmons Virtual Community Cleanup September 1 – November 30, 2020 Thank you for participating in this year’s virtual Community Cleanup. Please follow these rules to ensure everyone stays safe during this cleanup. • DO NOT TAKE ANYTHING THAT IS NOT YOURS • All volunteers must wear reflective vests • All volunteers must wear gloves • All volunteers must wear a mask and practice social distancing • No more than six (6) people to a group • Stay off the railroad tracks if you are assigned that area. • Each group must appoint a spotter/supervisor to watch for traffic and to protect the group • Streets must be crossed as a group, no individuals wandering in the street or crossing alone • Must cleanup both sides of the street • Everyone must walk facing on-coming traffic and not have their backs to the traffic. • Stay within the right of way. Do not go into people’s yards. • Everyone needs to watch what they pick up. If it looks suspicious (ex: drug paraphernalia), or looks like chemicals/batteries, or anything in this nature, please call us to report it. • Be careful with “stuff” in bags. Do not stick your hand down in any paper or plastic bags. • Do not open anything with liquid, or is taped shut. • Tie up bags once they are ½ to ¾ full and leave on the side of the road for pickup. • Leave all political signs alone

  8. Leave This Blank:

  9. This field is not part of the form submission.