Recreation Retreat Registration – North Dakota Association of the Blind

Thank you for your interest in the NDAB Sports and Recreation Retreat. Please use the form below to register.

Registration Form

Your Name (required)

Are you a person with vision loss, or a guest?

Person with Vision LossGuest

Street Address 1 (required):

Street Address 2:

City (required):

State (required):

Zip Code (required):

Home Phone:

Cell Phone:

Your Email (required)

Are you under 18?

YesNo

Emergency contact person (required)

Relationship (required)

Phone Number (required):

Name of Physician (required)

Phone Number (required):

Will you be bringing a guest with you?

YesNo
(If so, they will need to fill out a registration form also.)

Guest Name

Relationship (friend, spouse, friend, teacher, Etc.)

Note: submitting the form will take a bit, so don't panic.