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National River Cleanup Day -
Saturday, May 20, 2017

Site Coordinator - Site Registration Form

Dear Potential Site-Coordinator,

If your neighborhood has a creek, river, or lake that is plagued by litter, we encourage you to register as a Site-Coordinator for that location at our next cleanup event: National River Cleanup Day on Saturday, May 20, 2017 from 9 am to noon.

The Creek Connections Action Group (CCAG) is a partnership of the City of Palo Alto, City of San José Departments of Environmental Services and Parks, Recreation and Neighborhood Services, City of Milpitas, City of Cupertino, City of Santa Clara, City of Sunnyvale, Santa Clara County Parks and Recreation, Santa Clara Valley Water District, and various other stakeholder groups. We have sponsored and organized over 36 creek cleanup events including the annual National River Cleanup and California Coastal Cleanup Days since our inception in 1996. To date, we have worked with over 20,000 volunteers who have removed over a quarter million pounds of trash around Santa Clara County.

As a site coordinator you will be responsible for volunteer recruitment (we will help with that), volunteer sign-in, review of safety tips, set-up and data reporting at your site on the cleanup day (CCAG will train you). The CCAG will also provide you with cleanup supplies for participating volunteers and will also provide a web site (www.cleanacreek.org), publicity materials to assist in providing information and recruitment and registration of volunteers for your site. 

Here is how you can get started:

Step 1:
Choose an accessible creek/river or lake site that is in need of a cleanup within Santa Clara County. Many coordinators choose parks or trails that have good creek access, public visibility and minimal vegetation. Please avoid areas with difficult terrain, homeless encampments or with dangerous litter. Please check your site’s condition before signing up.
 
Step 2:
Arrange for one or two people to serve as Site-Coordinators for the day of the event. The site coordinator(s) must participate in our training meeting/supply pick-up session on Thursday, May 11, 2017, from noon to 1:30 p.m.  Food will be provided!
 
Complete this registration form by Friday, March 10, 2017.

Participation in this event is a great way to work with residents to protect and care for our local waterways and environment.

If you have any questions or need site suggestions, please send an e-mail to volunteer@valleywater.org.

We look forward to working with you!

- Ricardo Barajas
  Creek Connections Action Group, Chair
  volunteer@valleywater.org
SITE COORDINATOR CONTACT INFORMATION
1.First name:
2.Last name:
3.If you are representing an agency, what agency (i.e. City of San José, Santa Clara County Parks, etc.)?
4.Address:
5.City:
6.Zip Code:
7.Phone Number:
8.Cell Phone:
9.Email:
10.Website (if applicable):
CLEANUP SITE INFORMATION
11.Name of creek, river, or lake:(Required.)
12.Closest street address to cleanup site (i.e. 2456 Creekside Rd. Palo Alto, CA ):
13.What city/town is the cleanup site in? (i.e. San Jose, Cupertino, Santa Clara, Palo Alto, etc.):
14.Starting and end points of cleanup (i.e. list cross street; Mckee Road and King Road):(Required.)
15.Select "Yes" if you currently have an active permit to cleanup the creek location above (i.e. current Adopt-A-Creek Program partner, etc.).

Select "No" if this is your first time participating or if you participated in Coastal Cleanup Day last year and would like to participate again this year (you will need to obtain another permit for National River Cleanup Day).

Select "I don't know" if you are not sure.
16.Where will volunteers meet before the cleanup (i.e. Meet at bridge; Meet at south entrance, etc.)?(Required.)
17.Number of volunteers needed (please estimate if not sure):(Required.)
18.Is parking available onsite?(Required.)
19.Condition of cleanup site:(Required.)
20.Is this site appropriate for participants under 16 years of age?(Required.)
21.Other information about this site (including level of litter, safety concerns, etc.):
22.Will you need assistance in disposing of collected trash after the event?(Required.)
23.If you answered "Yes" on Question 22, where will the collected trash be left at (i.e. On the corner of X and Y; By the bridge, etc.)? Please give a cross street for more accuracy.
24.Would you like to register volunteers via EventBrite (EventBrite is an online application that allows volunteers to register for your cleanup site)? Volunteers will still have to sign a waiver and registration form, EventBrite is only used to monitor the level of volunteers you will potentially receive at your site.(Required.)
25.Is this cleanup site for your group only (i.e. Boy Scouts; Girl Scouts, Church group, etc.)?(Required.)
26.What personal contact information would you like to list on the website (www.cleanacreek.org) to connect with potential volunteers if they have questions:(Required.)
27.Do you have any other comments, questions, or concerns?
Thank you for taking the time to fill out this online site-coordinator form for National River Cleanup Day on Saturday, May 20, 2017. You will receive a confirmation email once your site has been verified and approved.

Please note that if the property you intend to cleanup is private property, you will need to obtain permission from the property owners. We cannot grant permission, nor should this form imply, that we grant permission to access private property.

If you have any questions, feel free to email volunteer@valleywater.org. Thanks again for your participation and help in keeping our waterways litter-free.