KABC register to adopt-a-spot or a one-off clean up
Do you want to register for a one-off clean up or to Adopt-a-Spot for ongoing clean-ups?
I want to do a one-off clean up
I want to adopt a spot to keep litter-free
We are a club with multiple sites
Proposed date of initial clean up
-
Day
-
Month
Year
Date
Does your group require insurance?
Yes
No
Number of people in your group
*
Please approximate if you are unsure
Type of organisation
Please Select
Individual
Family
Business/corporate
Community/service
School
Early learning group
Other
Group or organisation name
If no group go to coordinator details
Group coordinator title
*
Group coordinator first name
*
Group coordinator surname
*
Coordinator address
*
Street address Note: For kit delivery a street address is required
Suburb
State
Post code
Coordinator phone number
*
Coordinator email
*
example@example.com
Name of clean up site
*
Address of clean up site
Street address
Street Address Line 2
Suburb
State
Post code
Local government area this site belongs to
e.g. City of Perth
Type of site
Please Select
Roadway
Parks/waterfront
River/creek
Beach/coastal
Public bushland
Shops/malls
School surrounds
Rest stop/station
Other
Note: If you are wanting to clean up a main road, for safety reasons it must have traffic volumes of less than 10,000 cars per day. You can check traffic volumes at https://trafficmap.mainroads.wa.gov.au/map
If other, please describe
Approximate size of the site
How did you hear about the Adopt-a-Spot program?
Please Select
Newspaper article
Friends/family
Workplace
School
Talking Rubbish e-zine
Event
Advertisement
Social media
Other
If other, please tell us how you heard about Adopt-a-Spot
I wish to save resources.
I can supply my own bags, gloves and tongs.
I require clean-up resources; please provide
Bags
Gloves
Tongs
Yes, I wish to rescue containers!
*
Send me a Containers for Change bag
More details or information
Declaration
*
Yes, I declare I do not have a criminal record that includes child-related offences
Submit
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