Guaranteed Ride Home Registration Fields with a red dot ⏺ are mandatory. Contact Information First Name Last Name Your E-Mail Address Address City State Zip Code Phone Number Use format xxx-xxx-xxxx Your Work or School Name & Location Identify Yourself I am employed. I am a student. You must select at least one. Employer or School Name School or Employer Address School or Employer City School or Employer State School or Employer Zip Code School or Employer Phone Number Do you require a wheelchair lift equipped vehicle? No Yes Verify That You Use Alternative Transportation Reference 1 First Name Please list one or more references who can verify that you use alternative transportation. Reference 1 Last Name Reference 1 Phone Number Reference 2 First Name Reference 2 Last Name Reference 2 Phone Number Reference 3 First Name Reference 3 Last Name Reference 3 Phone Number Which Transportation Do You Use Most Often? Transportation ABQRide Buses Carpool Mini Ride (Mobility Impaired) Vanpool Bicycle You may choose more than one. Comments or Additional Requests Enter here I, the participant, have read and understand the guidelines of the Guaranteed Ride Home (GRH) service. I hereby certify that I qualify for the GRH by traveling to and from my workplace or school by carpool, vanpool, ABQ RIDE bus, Mini Ride, or bicycle. I, on behalf of my heirs, successors, or assigns, hereby release and hold harmless my employer, and the City of Albuquerque from any liability, claims, and demands of any kind whatsoever, including but not limited to, any liability for personal injury, loss, theft or damage to my personal property, loss of income, consequential damages resulting from delays or absence of a shuttle, or termination of the service. Furthermore, I understand that if I incorrectly use this service I may be restricted from using GRH again. Captcha Register for Guaranteed Ride Home
