Form Center

2. *This form is for groups that have formally adopted a stream through the Adopt-A-Stream Program. If you are interested in adopting a stream or hosting a one time cleanup, please email sphilbin@rockvillemd.gov.*
4. Stream Cleanup Details

   Stream cleanup dates and supply requests must be submitted via this form no later than two weeks prior to the event date. This ensures that we can coordinate supply drop-off and trash pickup. If you need confirmation on your trash pick-up location, please email sphilbin@rockvillemd.gov.

6. Stream Section*
   -- Select One --CJ-01 Elwood Smith ParkCJ-02 Upper Dogwood ParkCJ-03 Lower Dogwood ParkCJ-04 Dawson Farm ParkCJ-05 Upper Ritchie ParkwayCJ-06 Lower Ritchie ParkwayCJ-07 Upper Potomac Woods ParkCJ-08 Lower Potomac Woods ParkCJ-09 Montrose Woods ParkCJ-10 North Farm ParkCJ-11 Cabin John Forest PreserveMP Monument ParkRC-01 Lincoln ParkRC-02 Northeast ParkRC-03 Maryvale ParkRC-04 West Civic Center ParkRC-05 North Civic Center ParkRC-06 Middle Civic Center ParkRC-07 East Civic Center ParkRC-08 Calvin ParkRC-09 West Rockcrest ParkRC-10 West Rockcrest ParkRC-11 Twinbrook ParkRC-12 RedGate parkWB-01 King Farm WestWB-02 King Farm EastWB-03 Upper Watts Branch - South of Gude DriveWB-04 Upper Watts Branch - Carnation DriveWB-05 Upper Watts Branch - Mainstem to Nelson StreetWB-06 Upper Watts Branch - College GardensWB-07 Anderson ParkWB-08 Upper Woodley GardensWB-09 Lower Woodley GardensWB-10 Welsh ParkWB-11 Thomas FarmWB-12 FallsgroveWB-13 Upper Watts Branch ParkwayWB-14 Upper Woottons MillWB-15 Glenora ParkWB-16 Boulder CreekWB-17 Lower Woottons MillWB-18 Winding RoseWB-19 Rockmead NorthWB-20 Rockmead SouthWB-21 Wootton High SchoolWB-22 Watts Branch Park MainstemWB-23 Horizon HillWB-24 Redland Blvd West TributaryWB-25 Redland Blvd East Tributary

   CJ = Cabin John, RC = Rock Creek, WB = Watts Branch

8. Cleanup Date*
   Cleanup Date
9. Cleanup Time
   Cleanup Time Start Time

   —

   Cleanup Time End Time
10. Number of Volunteers*
12. Team Leader Name*
13. Group Name*
15. Phone
16. Email*
20. Form Download
22. Group Volunteer Liability Waiver Form
    Click here to download the Group Volunteer Liability Waiver Form

    All volunteers must sign the waiver form. The completed form must be returned to Shannon at sphilbin@rockvillemd.gov.

23. Stream Cleanup SSL Form
    Click here to download the stream cleanup SSL form.

    This form is pre-filled with the City's information. The service record in Section II must be completed by the stream cleanup leader.

25. Supply Request

    Supplies will be dropped off with no-contact to the address indicated below no later than 3 days prior to your cleanup date. Walk-in supply requests to City Hall cannot be accommodated. 

27. What supplies do you need for your cleanup?*

    1. Trash Bags
    2. Gloves
    3. Paper SSL Forms
    4. Trash Grabbers
    5. None
29. Number of trash bags requested:
31. Number and sizes of pairs of gloves requested:
    Available sizes are Youth (ages 8 and up), Small, Medium, Large and Extra-Large.
33. Number of paper SSL forms requested:
35. Number of trash grabbers requested:

    Limit of 10 per group. Please reuse grabbers for each event. 

37. Supply Drop-Off Address
39. City
40. State
41. Zip
43. Special instructions for supply drop off:

    Ex. leave at front door, on porch, front desk etc.

Leave This Blank:


45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit

* indicates a required field