Community Clean-Up Volunteer Registration Form

Saturday, October 20th
8 a.m. – 12 p.m.
Meet at Beebe City Hall

Must complete a separate form for each volunteer.

Minors must have parent/guardian permission and provide parent/guardian contact information.

Deadline to register is Monday, October 15th.

View Printable Flyer

(If no email address, please provide mailing address)
Under 18?
If you are under the age of 18, please fill out the parent or guardian information below or you WILL NOT be allowed to participate.
I agree to be a volunteer in the City of Beebe Community Clean-Up Program and commit to the tasks assigned to me. I understand that it is my responsibility to adhere to, and comply with, the policies and procedures as indicated by the event coordinators. I agree to release and discharge the City of Beebe, its agents and employees, and all other persons associated with the Beebe Community Clean-Up Day from liability for any injuries, accidents, or physical conditions I may suffer during the event, claims, costs, and damages, including but not limited to those arising out of or related to my participation as a Community Clean-Up Volunteer. I grant full permission for Beebe Community Clean-Up Day to use my name, likeness, voice, photographs, videotapes, or quotations from me in accounts, promotions and activities, in any medium, related to any Beebe Community Clean-Up Day events. I fully understand this agreement and I am aware that this is a release of liability between the City of Beebe, the Beebe Community Clean-Up Day and myself.