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Adopt-a-Park Program - Activity Log
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Steps
1.
Step One
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2.
Contact Information
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3.
Volunteer Hours
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4.
Activity Log
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5.
Data Collection Consent & Submission
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Step One
Registered Adopt-a-Park program volunteers, please complete an activity log after each visit.
Date
*
Date
Select the program you participated in:
-- Select One --
Adopt-a-Pollinator Hotel
Adopt-a-Sports Library
Adopt-a-Trail
Trail Section
If applicable, what section of trail did you volunteer for?
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Contact Information
Group, Organization or Family Name
*
Contact Name
Phone Number
*
Email Address
*
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Volunteer Hours
Volunteer 1
Name
*
Hours Volunteered
*
i.e. 1 hour 30 minutes
Volunteer 2
Name
Hours Volunteered
i.e. 1 hour 30 minutes
Volunteer 3
Name
Hours Volunteered
i.e. 1 hour 30 minutes
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Activity Log
Was there debris or garbage in the water?
*
Yes
No
If "Yes", please describe type of debris or garbage and location.
Did you notice any dumping activity?
*
Yes
No
If "Yes", please describe type of dumping activity and location.
Was any graffiti found?
*
Yes
No
Please comment on the nature of any graffiti you may have found.
Was any vandalism found?
*
Yes
No
Please comment on the nature of any vandalism you may have found.
Were any trail hazards found?
*
Yes
No
If "Yes", please describe type of hazard and location.
Additional Comments
Did any injuries occur during the volunteer work?
*
Yes
No
If Yes, fill out a first aid report and contact City Coordinator immediately.
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Data Collection Consent & Submission
Data Collection Consent
*
By checking "I consent" you are consenting to the voluntarily collection and use of your personal information in accordance with Section 26(d) of the Freedom of Information and Protection of Privacy Act (the “Act”). The information provided by you will be used solely for the purposes of the Adopt-A-Trail Program and will not be used for any other purpose. If you are submitting personal information on behalf of another individual you acknowledge that you are either their legal guardian or have obtained their consent in accordance with Section 27(1)(a)(i) of the Act. If you have any questions about the collection, storage, correction and/or use of your personal information please contact Jennifer Urbaniak – City of Coquitlam, Parks Program Coordinator, 500 Mariner Way at 604-927-6312.
I consent
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