Request edit access
"Come As You Are" Adaptive Kayaking Open House Registration Form
Completing this registration form in its entirety will help us get you signed up for the Open House Adaptive Kayaking programs at Wyndham ABQ Surf N' Slide or Rio Rancho Aquatic Center.

You will be sent an invoice via Paypal about a week before the day of the event. Please pay the invoice before noon of the day of the event. If you completed the registration form and clicked the "Submit Form" button, you will receive a confirmation email stating that you have successfully registered for the Adaptive Kayaking Open House. If you DO NOT receive a confirmation email of your registration for the open house, something has gone wrong with the registration process - please make sure you clicked the "Submit Form" button at the end of the form. Please contact Jane Bales at Jane@kayaknewmexico.org if you need help.

Email address *
General Information
The information below will help us communicate to you regarding this event, registration fees, waivers, cancellations, etc.

In general, we do not prefer to communicate directly with minors, or those who cannot make decisions regarding their participation in this event. Therefore, in this section, we would prefer parent, legal guardian, or care giver information when applicable.

First name *
First name of the primary contact
Your answer
Last name *
Last name of the primary contact
Your answer
Email address *
Email address of the primary contact
Your answer
Confirm email address *
Email address of the primary contact
Your answer
Phone number *
Phone number of the primary contact format: 123-456-7890
Your answer
Mailing Address - NOT REQUIRED FOR REGISTRATION
We often depend on community partners to help facilitate promotion of these events. Providing us with your address (optional) will help us minimize time and cost. It also helps us communicate as email marketing becomes less reliable. You may receive a quarterly newsletter, or postcard of upcoming events.
Street address
Your answer
City, State, Zip-code
Your answer
Areas of interest - NOT REQUIRED FOR REGISTRATION
Select one or more areas of interest
How did you originally find out about our adaptive kayaking programs? NOT REQUIRED FOR REGISTRATION
Check the most relevant referral source, or add it in the "other" field below.
Next
Never submit passwords through Google Forms.
This form was created inside of Kayak New Mexico, Inc. Report Abuse - Terms of Service