2023 Signup Form for the International Coastal Cleanup in Virginia
The 2023 Virginia Waterways Cleanup initiative is part of the Ocean Conservancy's annual International Coastal Cleanup (ICC). All ICC events in Virginia are coordinated by Clean Virginia Waterways of Longwood University.

WHEN: Cleanup events are held between late August and early November, but we also encourage year-round cleanups!

WHERE: As a site captain, you can choose where volunteers clean litter, such as a local park, neighborhood, stream, or beach. However, make sure to follow all regulations and hours of operation for beaches and parks.

WHAT MAKES THE ICC SPECIAL AND IMPACTFUL: CVW encourages cleanup volunteers to collect data about the trash they find. This helps us and other organizations understand trends and create solutions to plastic pollution. You can collect data using a paper data card or through the CleanSwell App on your phone. Read more here: http://www.longwood.edu/cleanva/VolunteerSiteCaptain.html. It can be QUICK and EASY to collect data -- just assign one or two volunteers to walk the cleanup area collecting data. They do not pickup litter-- just record what they are seeing. That leaves all your other volunteers free to concentrate on removing litter. 

QUESTIONS: For questions and concerns, please call (434) 395-2602 or email cleanva@longwood.edu.

Please join the global effort to guarantee trash free seas by signing up today!
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First Name *
Last Name *
Have you participated in an International Coastal Cleanup event in a previous year? *
Name of organization, family, school, park, or business (this name will be printed on your certificate) *
Mailing Address, Line 1 (CVW needs your address so we can mail you a certificate, safety guidelines, trash bags and a bandana. If you do not want these items, type "NA" in the address fields.) *
Mailing Address, Line 2
City *
State *
Zip Code *
Cleanup Site Location (Name of park, neighborhood, stream or beach you will be cleaning) *
County (or incorporated town) *
Date of Cleanup (if known. You can tell CVW the date later.)
MM
/
DD
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YYYY
Contact Email for CVW to use to contact you. *
Your phone number for CVW to contact you. (Optional)
Which best describes your cleanup site? *
Required
CLEAN SWELL (The app for smart phones)
Clean Virginia Waterways encourages you to use the CLEAN SWELL app to collect data.  Please download this FREE app onto your smart phone or tablet, and try it out. IMPORTANT: Be sure to type in the number of volunteers and an estimate of the pounds you collect!  If you prefer to collect data with the good old paper "Marine Debris Data Forms"-- please download it ! As long as we get data from your volunteers about the types and quantities of trash the are finding, we are HAPPY!!
Will you collect data for us this fall? *
Required
Safety is our priority! Please read the safety guidelines on this page (http://www.longwood.edu/cleanva/SafetyPlan.html), then check the box below.
Liability Waiver: In checking this form, I acknowledge that there are risks and hazards associated with cleanup events and I agree to assume all such risks and the possibility of hazards to me, my child (children), and all real or personal property, and do not hold Clean Virginia Waterways, property owners, Site Captain, or other associated organizing group(s) responsible. I recognize that by signing this document I am waiving certain rights, including the right to sue.
Is your Cleanup event Open to the Public, or is it private (for members of your group)?
Clear selection
Is there anything else we need to know about your cleanup event?
Would you like your cleanup to be listed on the Clean Virginia Waterways' webpage for 2023 events? If yes, then please tell us what you want us to share about your cleanup (meeting location, pre-registration requirements, etc.)​. *Only if your cleanup is public *
If you want CVW to send you some trash bags, please tell us the number of bags you would like. Usually, it is 2 bags per volunteer. *
If you want CVW to send you some gloves, please tell us the number of PAIRS you would like. (While supplies last) *
If you want CVW to send you some Data Cards, please tell us the number of cards you would like. Usually, it is 1 data card per 3 volunteers. *
How many estimated volunteers will participate in your cleanup? *
Thank you for signing up for the ICC in Virginia! Your donation of time is so appreciated!
A certificate, safety guidelines, and one super-special bandanna (while supplies last) will be sent to each group doing a cleanup this fall. Please contact us if you have any questions or have special needs.

Clean Virginia Waterways
Longwood University
201 High Street
Farmville, VA 23909
Email: cleanva@longwood.edu
Phone: 434-395-2602
Fax: 434-395-2978
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