CommuteFit Registration Form

COMMUTE v.: to regularly travel from one place to another.
FIT adj: physically sound; healthy

CommuteFit LogoTogether they make Commute Fit, CommuteWorks newest commuter incentive program that makes getting to work fun and healthy. Commute Fit rewards commuters who bike, walk, jog, or rollerblade to work.

Sign up for Commute Fit at no cost and receive the basic registration kit containing all the materials needed to log miles and earn incentives.  The registration kit helps you to keep track of the miles you bike, walk, jog, or in-line skate to work.  As your commuting miles add up, you earn incentives for your efforts.

Fill out the form and press the submit button to start the registration process today!

Commuter Information:
Full Name:
Home Address:
Apt:
City:
State:
Zip:
Home Phone:
Work Phone:
Fax:
Email Address:
 
Your Mailing Address (if different from home address):
Address:
City:
State:
Zip:
 
Employer Information:
Employer:
Department:
 
I plan to:

 walk to work

  

bike to work

  

jog to work

  

skate to work

  
Round trip miles from home to work:
 		  
Please indicate the number of days you will be riding,biking, walking or skating to work:
 

 
Thank you for your interest in CommuteWorks' CommuteFit program. By submitting this form, you state that you have read and agree to the Authorization to Release Transportation Information notice, below.

The CommuteWorks Coordinator will contact you soon.

Authorization to Release Transportation Information

By registering for these programs you authorize CommuteWorks to release information provided by you to those requesting information concerning transportation sharing to and from the Longwood Medical and Academic Area. In registering you understand that this information will be distributed to those requesting ride share information, and through the CommuteWorks Website, Transportation Kiosk, Emergency Ride Home Program, and the Pool-Aide Program.

By registering this document you hereby agree to hold harmless, release, waive, forever discharge and covenant not to sue or bring claim against CommuteWorks, MASCO, their subsidiaries, officers, agents, and, or employees from any and all claims and demands whatsoever which the undersigned or any third party, and the representatives thereof may have against said company, its subsidiaries, officers, agents, or employees by reason of the distribution of such information.

  

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For questions, comments, or additional information,
email CommuteWorks or use the address or phone number below.
 

CommuteWorks, a service provided by MASCO, Inc
 375 Longwood Avenue, Boston, MA 02215-5328

(617) 632-2796