Confluence Trash Bash – Pagedale City Hall Fill out the form below to register for the Pagedale City Hall cleanup site Name* First Last Email* Zip Code* ZIP / Postal Code PhoneT-Shirt Size (adult sizes only)SmallMediumLargeX-LargeXX-LargeWhat will your age be on the day of the Confluence Trash Bash (March 21, 2020)?*May we ask you a few demographic questions? This information helps us plan events and programs that reflect the people we serve. Yes No DemographicsWhat gender do you identify as? Male Female Non-binary/ third gender Prefer not to say Please specify your ethnicity (Choose as many as apply) Caucasian African-American Latino or Hispanic Asian Native American Native Hawaiian or Pacific Islander Other/Unknown Prefer not to say Additional RegistrationsWould you like to register any additional people for this event?* Yes No
