Greener City Registration

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I Want To
- Apply For
- Find Out About
- Pay or Claim
- Register or Reserve
- Report

Greener City Registration

Name *

First

Last Name *

Last

Phone

Are you a Port Coquitlam Resident?

Yes

Will you be bringing more than one person to this event?

Yes

Please provide first and last names of those in your group.

Which date will you be attending?

Would you like to be informed of the next greener city event?

Yes

I give consent to the City of Port Coquitlam [the City], to use and publish images, video [“the Images”] of myself and/or my family for promotional or any other lawful purpose in any manner or medium, and to alter the same without restriction and without the payment of any compensation.

I waive any right to notice or approval of any use of the Images;

I release the City and its agents or assigns from all claims and liabilities relating to the Images of myself or by virtue of alteration, processing or use in composite form.

I do not give consent.

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