Please complete this form after your event. Thank you for helping to keep Hamilton Clean and Green. Answers to fields and questions with an asterisk ( * ) are mandatory Contact Information Contact Name * Phone * Email * Group * Event Details Select your Clean Up Event * Adopt-a-Park Date of Clean Up * Year Year20202021202220232024 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Day Day12345678910111213141516171819202122232425262728293031 Start Time Hour Hour123456789101112 : Minute Minute0030 am pm End Time Hour Hour123456789101112 : Minute Minute0030 am pm Number of Volunteers * Location of Clean Up * Community Clean Trailer Used * Yes No Clean Up Successes Orange bags collected: Clear bags collected: Bulk items found: Graffiti tags removed: Illegal dumping reported to 905-546-CITY (2489) Yes No Beautification Leaf and yard waste bags collected: - None -123456789101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960616263646566676869707172737475767778798081828384858687888990919293949596979899100 Trees planted: Shrub beds weeded: Trees woodchipped: Additional Comments Collection Notice The City of Hamilton collects information under authority of Section 227 of the Municipal Act, 2001. Any personal information collected through the volunteer agreement form for the Hamilton Adopt A Park Program will be used for communicating volunteer clean ups and training information. By providing your email address, you are consenting to receiving emails from the City of Hamilton and/or their agents/contractors for purposes related to this program. Information collected for this initiative may be stored on servers located in Canada and the United States and may be subject to Canadian and/or American laws. Questions about the collection of this personal information can be directed to Community Liaison Coordinator, Public Works Department, 71 Main St W, Hamilton Ontario 905-546-2489 and [email protected]. Leave this field blank Date modified: 2021-03-29
