COMMUTER INCENTIVE PROGRAMS

WORKOUT TO WORK - BIKE
Cycle Commuter Health Club Subsidy

Registration Form

In order to enroll in the Cycle Commuter Health Club Subsidy Program, you must already be registered in our Workout to Work Program - BIKE.
You must be an employee or resident of a Seaport TMA Member Company.

Note: In order to make the program fair and open to as many commuters as possible, previous participants are not eligible.

Name: 
Month to Begin Participation:
(Usually the month following when you register.)
Home Address: 
City, State, Zip: 
Employer: 
Work Address:
(Please include any mail zones/dept. codes/etc.)
City, State, Zip:
Work Phone: 
Email Address:
Supervisor's Name:
How did you learn about the program?
How do you currently commute to work?
What locker room facilities, if any, do you currently use?
How many miles (one way) is your commute?
How many days a week do you commute by bike?  
Normal arrival time at work:
Normal departure time from work:

Terms of Agreement for Cycle Commuter Health Club Subsidy (Please check each box on the left below)
I request to participate in the Seaport TMA's Cycle Commuter Health Club Subsidy program.
I hereby release the Seaport TMA and all service providers from any liability, claims and demands for personal injury, loss, theft or damages to my personal property, loss of income, consequential damages resulting from delays or absence of service provider, or termination of the program. I also understand that the Seaport TMA has the right to discontinue participant privileges at any time.
Furthermore, I understand that incorrect use of this program may result in restriction from participating in the program.


 

 

Seaport Transportation Management Association
200 Seaport Boulevard, Mailzone Z1A  •  Boston, MA 02210
(617) 385-5510 phone  •  (617) 385-1788 fax
 SeaportTMA@fmr.com