Exit this survey

1. Complete the Registration Below:

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* 1. Your Name:
(One name per registration)

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* 2. Are You Coming as Part of a Group? (If yes, list group name)

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* 3. Give Us Your Email Address! - We will send you an email confirmation

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* 4. Is Participant over 18 Years Old?

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* 5. Would you like to join one of our Adopt-a-Block groups at a neighborhood clean-up?

Please Note:

Adult supervision is NOT provided by the City of Hayward at this event. All volunteers under the age of 18 must be accompanied by a participating adult in their group.

Participant Agreement:

I, the undersigned, being of lawful age or the parent or legal guardian of the volunteer involved in the City of Hayward litter pick-up effort, in consideration of being allowed to participate in this effort, hereby release, discharge, and by these presents do for myself, my marital community, heirs, executors and assigns, release, acquit and forever discharge the City of Hayward, a municipal corporation, and its officers, agents and employees from any and all actions, causes of action, claims or any other thing whatsoever on account of or in any way related to or arising out of my participation in the City of Hayward litter pick-up event.

Further, I assume liability for any non-participants who accompany me. By clicking the DONE button, I agree to the terms stated.

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