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Highway Clean-Up
All participants must be registered.
40 Hill Spring Meadow
Balzac, AB T0M 0E0
Registration Form
Highway Clean Up Registration 2022
On May 7, we will be cleaning 24 km's of ditches along the highway for the province of Alberta. We will also be enjoying an excellent picnic lunch and time together.
Can we count you as one of the participants?
Please fill out this form.
Your Name
*
First Name
Last Name
Your Email Address
*
Your Cell Number
*
(###)
-
###
-
####
Health Questions
*
No Fever
No unexplained throat, nose, symptoms
No unexplained cough
Not presently required to quarantine or isolate
Are you registering any other participants?
*
Yes
No
Please fill out for each participant you are registering
Age
>
Kid (9 to 11 years of age)
Teen (12-17 years of age)
Adult (18 years )
Participant's Name
First Name
Last Name
Health Questions
*
No Fever
No unexplained throat, nose, symptoms
No unexplained cough
Not presently required to quarantine or isolate
More participants
Yes
No
Please fill out for each participant you are registering
Participant's Age
>
Kid (9 to 11 years of age)
Teen (12-17 years of age)
Adult (18 years )
Participant's Name
First Name
Last Name
Health Questions
*
No Fever
No unexplained throat, nose, symptoms
No unexplained cough
Not presently required to quarantine or isolate
Another Participant?
Yes
No
Please fill out for each participant you are registering
Participant's Age
>
Kid (9 to 11 years of age)
Teen (12-17 years of age)
Adult (18 years )
Participant's Name
First Name
Last Name
Health Questions
*
No Fever
No unexplained throat, nose, symptoms
No unexplained cough
Not presently required to quarantine or isolate
Bridges Church