Applicant Form

01

Tell Us About Yourself

Basic contact information so we can get in touch.

Full Name *

Phone Number *

Email Address *

City / State

02

Participant Information

Help us understand who’s joining us on the trail.

Are you applying for yourself or someone else?

Myself Someone else

Date of Birth

Height & Weight (for vehicle safety/fit)

Type of Disability (optional — check all that apply)

Physical Cognitive Both Prefer not to say

Brief description of mobility limitations or needs (optional)

03

Accessibility & Support Needs

This helps us make the experience work for you.

Do you use any mobility aids? (check all that apply)

Wheelchair Power Wheelchair Walker Cane Prosthetic None Other

Can you transfer independently into a vehicle?

Yes No With some help

Any sensory sensitivities or cognitive considerations? (optional)

Preferred accommodations (optional)

04

Experience & Comfort Level

Helps us match you with the right setup.

Have you ridden in or driven off-road vehicles before?

Yes No

Comfort level with off-road adventure (1 = easy & gentle, 5 = full send)

1 Easy & Gentle 2 3 4 5 Full Send

I’m interested in:

Driving Riding as a passenger Either works for me

05

Medical & Safety Info

Keeps you and our team safe on the trail.

Relevant medical conditions (optional)

Medications that may affect participation (optional)

Allergies (optional)

Physician clearance on file or required?

Yes No Not sure

06

Media Release

Stories inspire others — but only if you’re comfortable.

Do you consent to photos/videos being used in our media?

Yes, happy to help! No, please keep me private Ask me on the day

I’d love to share my story — feel free to reach out!

07

Liability Acknowledgment

Not a waiver — just an honest heads-up before you arrive.

I understand that off-road activities involve inherent risks, and I am choosing to participate with that awareness. I agree to follow the instructions of Wide Open Access staff at all times during the experience. I acknowledge that a formal liability waiver will be required upon arrival and that this application does not constitute that waiver.

08

Anything Else?

This is your space — tell us whatever you’d like us to know.