Adopt Cedar Hill Cleanup Notification Form

2. 

3. Adopt Cedar Hill Advanced Notification Requirement
   The City must be notified seven (7) days in advance of the exact date of the cleanup so that arrangements can be made to have the trash bags disposed of promptly.

   The City must be notified seven (7) days in advance of the exact date of the cleanup so that arrangements can be made to have the trash bags disposed of promptly.

5. Name of Adopter/ Applicant/ Organization*

6. Contact Person/ Authorized Representative*

7. Phone Number*

8. Email*

10. Date and Time of Cleanup*
    Date and Time of Cleanup

    Date and Time of Cleanup

11. Location of Cleanup*

12. All requests for cleanup supplies and trash pickup must be made at least seven (7) days prior to the cleanup event.

14. Do you need safety vests?

    1. YES, I need safety vests.
    2. NO, I do not need safety vests.

15. How many safety vests do you need?

    Disregard this box if you do not need safety vests.

16. Do you need trash grabbers?

    1. YES, I need trash grabbers.
    2. NO, I do not need trash grabbers.

17. How many trash grabbers to you need?

    Disregard this box if you do not need trash grabbers.

19. Do you need trash bags?

    1. YES, I need trash bags (4 bags)
    2. NO, I will supply my own trash bags.

20. Do you need gloves?

    1. YES, I need gloves.
    2. NO, I do not need gloves.

21. Do you need cooling towels (summer cleanup) or beanies (winter cleanup)?

    1. YES, I need cooling towels (summer cleanup).
    2. YES, I need beanies (winter cleanup).
    3. NO, I do not need cooling towels and/or beanies.

22. Do you need staff to pick up your filled trash bags?

    1. YES, please pick up my trash bags.
    2. NO, I will dispose of my trash bags.

    Place filled trash bags under the Adopt Cedar Hill sign or next to the closest public trash can if the cleanup is in a park.

24. Required Form
    Cleanup Report

    Cleanup Report must be submitted within five (5) days of a scheduled cleanup event to receive credit. Photos are highly encouraged.

25. Required Form
    Safety Tips for Volunteers (PDF)

    Hand a copy of the safety tips to every volunteer OR read aloud before the cleanup event begins.

Leave This Blank:


27. 1. Receive an email copy of this form.
28. Email address

    This field is not part of the form submission.

29. Submit

* indicates a required field