JOIN THE FIGHT! CHIQUITA CANYON LANDFILL LITIGATION We are recommending each adult (18+) in your household to complete a contact form. Once completed, you will automatically be redirected to our Health Survey and one of our staff members will reach out to you with your next steps in joining. Name * First Name Last Name Email * Phone * (###) ### #### Home Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Approximate Distance from Landfill * Community Residing In * Val Verde Castaic Canyon Country Hasley Hills Hasley Canyon Hillcrest Live Oak North Bluffs Piru Sagus Williams Ranch Valencia OTHER *(please write in additional information section) If you answered "Other" above, please write the community below: Work Address & Hours at place of Work If you are joining due to your work location, please answer below. We are recommending every Adult in your household (18+) sign up as well. If you have any others residing with you, who would like to sign-up, please enter their contact information below: Full Name, Phone, Email, & Relationship If you would like a copy of the agreement in Spanish, please check 'YES' below: YES Additional Comments/Concerns:
