Dirtybird Campout West 2019 - ADA Camping Registration
Full Name *
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Email Address *
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Confirm Email Address *
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Phone Number *
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What type of camping have you purchased? *
Required
Please provide your Camping Order Confirmation Number. If you have not purchased a camping pass, please enter "NA". *
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What day will you be arriving? *
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Will you require access to an accessible shower? *
Will you require ADA shuttle transportation? *
Will you need electricity to charge medical equipment? *
If there is any other way we can assist you in regards to camping and shuttle transportation, please email us at ada@dirtybird.com. Once you submit this form, you will be confirmed for a camping spot and do not need to follow up with us. You will need to come our Access Center onsite to register as an ADA patron, and then you will be all set! *
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