Driving Out Cancer Registration

September 26, 2026 Picklr Albuquerque East 10:00 AM - 2:30 PM

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Registration Form

Please fill out the following form to register for the Cancer Services of New Mexico Driving Out Cancer event.

Your Information

Name Street Address City

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Phone Number Email

Car Information

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I understand the registration fee is $25 and is required for including my vehicle. My registration is not complete until the payment is submitted. Pay the $25 registration fee with PayPal. Waiver/release statement: I agree that neither Cancer Services of New Mexico (CSNM), Picklr Albuquerque East, nor their employees, agents, or volunteers associated with Driving Out Cancer shall be held responsible for any injuries, damages, or loss of personal property that occur to myself or others who participate with me while attending, participating, or witnessing any Driving Out Cancer activity. I assume full risk, waive all claims, and release and hold CSNM and Picklr Albuquerque East, and their employees, agents, or volunteers associated with Driving Out Cancer, harmless for any and all claims for injuries or damages. Photo/video release statement: I grant permission for myself and others who participate with me to appear in person or in voice, video, or photographic presentation for radio, television, print, or digital media resulting from participation in Driving Out Cancer.