James River Advisory Council (JRAC)

Register for the James River Regional Cleanup
June 13, 2009, 9 a.m. - 1 p.m.

Registrants under the age of 18 must be accompanied by an adult to sign Liability Form.

Last Name (Apellido)

First Name (Nombre)

Site Staff

Organization (If any) (Afiliacion)
examples: BSA Troop XXX, FoCR, Sponsor

Mailing Address (Direction postal)

City (Ciudad)

State (Estado)

Zip Code (Codigo postal)

Phone Number

EMail Address (EMail)

Cleanup Site (select one) (Sitio de particpation)
The registrations at Powhatan County -Maidens Landing and Henrico County - Horsepen Branch have reached maximum capacity. Please select an alternate location.

Number of people (Numero de personas)

Check if you plan to bring a boat or canoe to the cleanup (Indique si Ud. piensa traer una lancha o canoa)

If so, how many boats or canoes (Cuantos)

Please tell us how you heard about the river cleanup (select one)
(Favor indicar como sup de esa evento)

Check if you need participation certificates for your group (Indique si requiere certificados de participaticion)

If so, how many? (Cuantos)

James River Advisory Council

James River Regional Cleanup

Calendar of Events

Kimberly Conley, Exec. Dir. PO Box 40 Chesterfield, VA 23832 (804) 748-1567 E-mail JRAC

Register for the James River Regional Cleanup June 13, 2009, 9 a.m. - 1 p.m.

Kimberly Conley, Exec. Dir.
PO Box 40
Chesterfield, VA 23832
(804) 748-1567 E-mail JRAC

Register for the James River Regional Cleanup
June 13, 2009, 9 a.m. - 1 p.m.