COMMUTER PROGRAMS

Workout to Work Registration Form

You will receive a welcome kit, opportunities to win monthly prizes and incentives as well as invitations to special events.

 
Last Name:   
First Name:   
   
Home Address:   
City, State, Zip:   
   
Employer:   
Work Address:
(Include mailzone/ mailstop if applicable)		  
Work City, State, Zip:
Work Phone: 
Email Address: 
(Work email preferred in order to verify employment with a TMA member company.)
   
I plan to: Walk
Bike
Also sign me up for the Bicycle Commuter Group.
Do you want a free Bike to Work t-shirt? Yes
 No thanks
T-shirt Size Small
 Medium
 Large
 Extra Large
Arrival Time at Work:
Departure Time From Work:
How many miles (one way) is your commute?
My average daily
Workout to Work Miles		  
In addition to walking/biking my other modes of commuting to work are: (Ex: transit, driving alone, carpooling, etc.).  Please list all modes.  
Referred by:
 
Terms of Agreement for Workout To Work:

By clicking "Submit Form" below, I agree to the following:

  • I request to participate in Seaport TMA's Workout to Work Program. I agree to read and abide by the procedures and rules of the program.

  • I hereby release 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 understand that Seaport TMA has the right to discontinue participant privileges at any time.

Return to Program Overview

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