PLEASE PRINT THE GENERAL LIABILITY RELEASE FORM ABOVE
READ, SIGN AND BRING TO THE EVENT TO VOLUNTEER
(If you do not have access to a printer, we will have forms available at the cleanup site.)

On-line Registration form for Cedar Rapids Flood Recovery Efforts
Please fill out and submit the form below. We will contact you via the email address you list, unless otherwise noted.

*Denotes a required field.

FOR MORE INFORMATION:

Shanon Reineke, Programs Coordinator, Living Lands & Waters
Email:shanonreineke@yahoo.com
Phone: 309.236-5627