Neighborhood Captain Sign Up

Student First Name Student Last Name Cell Phone Email Address Name of Student's School County If you are part of a team, enter your team name If referred by someone, please enter their name. Street Address City State Country Zip Code Parent or guardian name (18 years or older) Parent's Email Parent Phone Number Waiver/Rules Acceptance

By clicking here, the Student and Parent / Guardian confirm that you have read the Rules & Regulations noted in the Neighborhood Captain section of this website and in the Release and Waiver.

I accept the Rules & Regulations and the Release and Waiver

NEIGHBORHOOD CAPTAIN - New Jersey

REGISTRATION

Next New Jersey Drive

Saturday, October 29, 2022

Drop Site: Fair Haven Fire House, 645 River Road, Fair Haven, NJ.

Next New Jersey Drive

Saturday, October 29, 2022

Please fill out the information below to sign up! If you are a member of a team, please indicate your team name in the field below.

Click here to view the Dermer Dreams Release & Waiver.

Dermer Dreams. Fighting Hunger... One Bag at a Time