Form Center

By signing in or creating an account, some fields will auto-populate with your information and your submitted forms will be saved and accessible to you.

Earth Day 2019

  1. Earth Day Logo

  2. Earth Day Neighborhood Clean Up

    Celebrate Earth Day by gathering with your neighbors and cleaning up your community! The Parks and Recreation Department is looking for residents to organize an Earth Day Clean-up event at one of the following areas: park, pond, rain garden, storm drain, or drainage ditch. You select the date, time, and project….we provide the supplies! Select a date anytime between April 13 and May 12.

  3. Type of group:*

  4. I am interested in cleaning up:*

  5. Please provide our group with the following supplies:

  6. Please include the following information on the neighborhood mailing:

  7. CONSENT TO RELEASE OF INFORMATION & RELEASE OF LIABILITY

    In consideration of your accepting this application, I authorize the City of Blaine to disclose to the City’s insurer, attorney, staff, coaches, participants and other personnel involved in this program the following information: name, address and telephone number. This information shall be used for the purpose of program administration. This consent to release information shall expire one year from the date of execution. I understand that the records are protected under the state and federal privacy regulations. I also understand that I may cancel this consent by a writing to that effect at any time prior to the information being released. I give my consent to use any photograph or video tape taken of myself for future promotional or marketing materials. In consideration of the City providing the registered activities, I agree to not hold the City liable for any claim resulting from participation in any such activity, including claims for injuries, death and resulting attorney fees. The completion of your registration signifies your acceptance of this consent.

  8. By checking this box, you agree to the waiver and liability clause above. *

  9. Leave This Blank:

  10. This field is not part of the form submission.