Clean Coast Trip Registration

First Name:*
Last Name:*
Cell Phone:
Home Phone:
Number of Adults:*
Number of Children Age 12 and Under:*
Which Trip Are You signing Up For:*
Comments or Questions:
Waiver of liability:  By signing up for this trip, I acknowlege that there is risk of injury or death and agree to hold Clean Coast, its officers, and boat captains harmless in the event of injury or death.  A paper waiver must be signed before embarking on a cleanup (insurance requirement).  Once per year, you must complete and sign a liability waiver. Please download a copy of the waiver by clicking here. Print it, sign it, and bring it with you. Thanks.