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Home Program > Registration Form
Emergency Ride Home Program
are required for enrollment in the program. This information will
not be shared by CRTMA.
* Please include any mail codes used at your
Taxi vouchers and program materials are sent via US Mail to your
work address only.
other, please describe:
Terms and Conditions for Employee Participation and
Release of Liability
By submitting this form,
I request to participate in the Charles River Transportation
Management Association's (CRTMA) Emergency Ride Home Program
("Program"). I have read and understand the policies,
procedures, rules and regulation of the Program, and I agree to
abide by them.
I understand that under
the rules of the Program, transportation will be provided to me by
a third party vendor, who is retained by the Charles River
Transportation Management Association. I also understand that the
CRTMA, its member organizations and my employer are not
responsible for the performance of the transportation vendor.
I hereby agree and state
that I am an eligible employee of a member organization of the
Charles River Transportation Management Association. I agree that
if I use the Program in an unauthorized manner, I will promptly
reimburse CRTMA for all damages resulting from the unauthorized
use of the Program. I further agree to use my best judgment in
participation in the Program and to faithfully adhere to all
safety instructions and recommendations, whether oral or written.
I hereby certify that I am a competent adult assuming these risks
of my own free will, being under no compulsion or duress. I
understand that my abuse of the Program may result in the loss of
my eligibility to use its services in the future.
I, by requesting to
participate in the Program, hereby assume full responsibility for
all risk of injury or loss, including death, which may result from
my participation in this Program and hereby agree to hold
harmless, release, waive, forever discharge and covenant not to
sue or bring claim against CRTMA, their officers, agents, members
and/or employees, and my employer, from any and all claims and
demands whatsoever which the undersigned or any third person, and
the representatives thereof have or may have against the said
company, officers, agents or employees, by reason of any accident,
illness, injury or death, or damage to or loss or destruction of
any property arising or resulting directly or indirectly from my
participation in the Program and occurring during said
participation, or any time subsequent there to, whether or not
such loss, injury or death is caused or alleged to be caused in
whole or in part by the negligent acts or omissions of the
company, their officers, agents or employees. The terms of this
release shall serve as a release and assumption of risks for my
heirs, executors, administrators and for all of my family members.
This Waiver and
Assumption of Risk is effective from the date of signature and may
not be revoked, altered, amended, rescinded or voided without the
express prior written consent of CRTMA. By my submission of this
form, I acknowledge that I have read the above Terms and
Conditions. I understand the terms of agreement and I have been
fully and completely advised of the potential dangers incidental
to engaging in the Program. I am fully aware of the legal
consequences of my agreement to these Terms and Conditions.
hit Submit now to send your information.
For More Information:
Email Us, or call (617) 324-6118.
P.O. Box 425255
Cambridge, MA 02142
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Charles River Transportation Management Association
238 Main Street, Suite 306 • Cambridge, MA 02142