Form

2013 Fall Brightside Community-Wide Cleanup
Contact Information

Please use proper capitalization and punctuation to help your friendly Brightside Staffer with editing. Thanks!
Organization/Team Name*
Prefix (Mr., Ms., Mrs.)
First Name*
Last Name*
Address
City
State
Zip Code
Day Phone
Cell Phone
Email Address*
First 5,000 registrants will receive a t-shirt.

Please note: All fields for t-shirt sizes require a numeric value, even if it is 0.
Youth Medium
Adult Small
Adult Medium
Adult Large
Adult X-Large
Adult 2X
Adult 3X
Will you be picking up supplies at the supply pick-up Saturday, October 12?*

Yes No
Supply pick-up will be Saturday, October 12th, at Iroquois Amphitheater from 10:00 a.m. to 12:00 p.m. Iroquois Amphitheater is located at 1080 Amphitheater Rd. in Louisville. At least one team member or individual needs to be present to pick-up the group's bags, gloves and t-shirts.
Cleanup Information
Will your group be cleaning up on Saturday, October 26th?*

Yes No
If no, please enter the date your group will be participating.
Cleanup Location- Groups choose their own location to clean.*
Please list the street corner(s) where you will leave filled bags of trash. Be as specific as possible for best results. NOTE: trucks may not drive on private property to pick up bags.*
Cleanup Zip Code
If you are not sure of your Metro Council district please use the Map It feature to find out.
Metro Council District of Cleanup
Group Gathering Location & Time*
Number of Volunteers (Numeric Value)*
Brightside provides T-shirts to the FIRST 5,000 registered participants. If a group fails to pickup their supplies on October 12, and they have T-shirts, the T-shirts go to other volunteers on a first come first serve basis. Groups who do not have t-shirts can call Brightside on Tuesday, October 15 to see if any T-shirts have been returned.
Groups select their own cleanup site, and Brightside offers FREE gloves and bags.

Please remember, if you do not attend the Supply Pickup your shirts will go back into the "General Population" and become eligible for groups who registered after the 5,000 volunteer point or who may need extra items.

Don't forget your supplies!
Successful cleanups can't happen without supplies, so please plan to send a member of your group to pick up your items.

Thanks for submitting your registration for the Brightside Community-Wide Cleanup. Any questions please call 574-4167.
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2013 Fall Brightside Community-Wide Cleanup

Contact Information

Cleanup Information

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