First Name      Last Name     Tee Shirt Size  S M L XL XXL

           Address  

                 City          State        Zip     

                Phone           Email       

        Group Affiliation (If participating in competition)

                  I certify I am over 18 years of age  (minors must have parents signature)    

                    I have a Pontoon boat that can be used to transport volunteers or haul bagged trash

           All boats provided will be covered with plastic on the inside and thoroughly cleaned afterwards.