Emergency Ride Home Registration

Eligibility

The Emergency Ride Home program is a benefit offered to carpoolers, vanpoolers, and bicyclists registered in GMTMA’s Ridesharing program. Commuters must participate in an alternative commute method at least once a week to be eligible.

Step 1 of 2 - Contact Information

Agreement:*
- Checking this box means I have read and agree to everything above. Checking this box is equivalent to your signature.
Name*
First Last
Email*
Home Phone*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Employeer*
Work Phone
Work Address
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Work Schedule*
How do you get to work? Check all that apply:
(Note: Those who drive alone every day will not qualify for this program.)
- Drive alone
- Carpool
- Vanpool
- Take bus or train
- Get dropped off
- Walk or Bike
Carpool or Vanpool Partners
If you belong to a carpool or vanpool, please enter the names of the other members of your carpool or vanpool in the box below.
Members:
Commuter Participation Agreement
The Undersigned Agrees to the following:
- I have carefully reviewed and understand the Program Rules of the Emergency Ride Home (ERH) program.
- I hereby certify that I am currently using the above method(s) of getting to work.
- I hereby release Greater Mercer TMA from any liability.
Participation Signature:**
- Checking this box is equivalent to your signature.

Emergency Ride Home Registration

Eligibility

Step 1 of 2 - Contact Information

Carpool or Vanpool Partners

Commuter Participation Agreement