Spring recreation retreat registration 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): AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Marianas IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaVirgin IslandsWashingtonWest VirginiaWisconsinWyoming 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): [group guest-selected clear_on_hide] Will you be bringing a guest with you? YesNo (If so, they will need to fill out a registration form also.) [group GuestYN clear_on_hide] Guest Name Relationship (friend, spouse, friend, teacher, Etc.) [/group] [/group] Note: submitting the form will take a bit, so don't panic. Δ
