Guaranteed Ride Home - Registration

Your Name & Mailing Address

First Name (Required)

Last Name (Required)

Address (Required)

City (Required)

State: New Mexico

ZIP Code (Required)

Phone Number (Required)

Email Address

Your Work or School Name & Location

Identify Yourself (Required)

You must select at least one.

I am employed.

I am a student.

Employer or School Name (Required)

Address (Required)

City (Required)

State: New Mexico

ZIP Code (Required)

Phone (Required)

Do you require a wheelchair lift equipped vehicle?

No
Yes

Verify That You Use Alternative Transportation

You must select one (Required)

Bus Pass Serial Number
One or more references who can verify that you use alternative transportation

Bus Pass Serial Number

References

Please enter one name and phone number per line.

Which Transportation Do You Use Most Often?

Transportation

You may choose more than one.

ABQRide Buses

Carpool

Mini Ride (Mobility Impaired)

Vanpool

Bicycle

Comments or Additional Requests

Enter here

I, the participant, have read and understand the guidelines of the Guaranteed Ride Home (GRH) service. (Required)

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.

City of Albuquerque

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Guaranteed Ride Home - Registration

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