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2. First Name
3. Last Name
5. Address1
7. Address2
9. City
10. State
11. Zip
13. Telephone:
15. Email:
    Email will be provided to the Great Lakes Alliance for volunteer registration.
19. Where do you plan to cleanup? Please be specific.
    i.e. Starting on Belknap St. and walking South on Baxter St., and stopping at 19th St. OR Section of WI Point beach between lot #1 and #2.
21. What day is your cleanup?
23. What time is your cleanup?
25. How many volunteers are in your group? Please list their names.
27. We recommend that volunteers throw collected garbage in their personal trash receptacles. Will you need additional help disposing of collected garbage (i.e., you anticipate collecting more garbage than your personal trash receptacle can handle)?
29. Are you able to follow all safety guidelines listed? See Below.
31. Comments:
35. Staying Safe

    In addition to wearing gloves, all participants are asked to follow these safety guidelines during their clean-up efforts:

37. 1. Wear a safety vest or a bright colored shirt, clothing that covers arms and legs, and closed-toed shoes or boots.
39. 2. Look all around you! Most trash gets blown around and ends up in rock and crevices or under trees and shrubs.
41. 3. Stay at least five feet from the edge of the road. When on or near a roadway, whenever possible face the on-coming traffic. Do not cross in front of traffic. Stay alert.
43. 4. Be mindful of water conditions. If along a creek or stream, use caution. Follow all safety alerts related to Red Flag conditions along Lake Superior.
45. 5. Avoid movements that will distract passing drivers or other volunteers.
47. 6. Do not wear headsets which could prevent you from hearing others or distracting you from other hazards.
49. 7. Do not attempt to retrieve items that may risk injury.
51. 8. Drink plenty of fluids– take breaks– avoid overexertion. Use proper lifting and bending techniques.
53. 6. Stop work in inclement weather.
55. 9. If you find hypodermic needles, please place the needle in the provided hypodermic needle container. Keep this separate from your trash. If you need us to pick up a needle or if you are not comfortable picking up hypodermic needles, please call the Needle Hotline at 218-730-4001. For removal, you can also call the Superior Fire Department at (715) 394-0227. After hours, contact 911.
57. 9. To remove dead animals, call Public Works at (715) 395-7334. After hours, contact 911.
59. 10. Don’t pick up any of the following items listed below. You can report items and location to Megan at hogfeldtm@ci.superior.wi.us or (715) 394-0392
61. a. Medical waste
63. b. Hazardous wastes including motor oil, gasoline, batteries.
65. c. Chemical containers or plastic bottles that smell or appear to contain noxious materials.
67. d. Sharp items (broken glass may be swept up with a broom/pan or picked up with a litter grabber)
69. e. Unusual, unidentifiable items
71. f. Appliances, televisions, furniture, or other large items that cannot be bagged
75. By signing, I agree to follow the safety guidelines as a volunteer with the September Coastal Cleanup in accordance with maintenance guidelines, liability terms, safety tips, and terms listed above.
77. First Name
78. Last Name
79. Date
81. Guardian (if volunteer is a minor)
82. Date
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84. 1. Receive an email copy of this form.
85. Email address

    This field is not part of the form submission.

86. Submit

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