Volunteer Registration

First Name: Last Name: Address: Address Line 2 City: State: Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming American Samoa Federated States of Micronesia Guam Marshall Islands Northern Mariana Islands Palau Puerto Rico U.S. Minor Outlying Islands Virgin Islands Armed Forces Americas Armed Forces Europe, the Middle East, an Armed Forces Pacific Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Territory Ontario Prince Edward Island Quebec Saskatchewan Yukon Territory Zip Code: - Zip Suffix Email: Day Phone: Date of Birth (mm/dd/yyyy): What best describes your gender? Female Male Non-binary Prefer to Not to Answer Prefer to Self Describe Self describe gender Are you a new or returning Dare2tri member? New Returning What is your involvement with Dare2tri? (Check all that apply) Do you have a disability? Primary disability: Amputee - Lower Limb Amputee - Upper Limb Blind/Visually Impaired Cerebral Palsy Muscular Dystrophy Multiple Sclerosis Spina Bifida Spinal Cord Injury Stroke/TBI PTSD Other None Please indicate any other disabilities (check all that apply): Number of Participants: As a one-on-one guide, are you comfortable piloting a visually impaired athlete on a tandem bike and running tethered? Yes No If you answered yes to the above question, what is your height? This helps with paring the guide and athlete together. If you have a coupon, please enter code here (case-sensitive):