Adopt a River Volunteer Registration

Today's Date

Year

Month

Day

Name *

Email (Impression 5 will not sell your email or add it to any newsletters) *

Phone *

Address *

City *

State *

Zip *

Reason For Volunteering

Group / Organization Name (if applicable)

Number of Volunteers in your Group

Preferred Cleanup Areas

Comments

I have read the waiver form attached, and by placing my initials in the form I consent and accept the waiver. *

Please add initials to the text box above.

I understand that participating in Adopt A River at Impression 5 Science Center, there is a risk of being exposed to COVID-19. *

Please add initials to the text box above.

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Impression 5
Science Center

200 Museum Drive, Lansing, MI 48933 517.485.8116