Carpool Form

Release of Liability 
The Carpool incentive program is designed to encourage employees of the Longwood neighborhood to carpool.  As a program participant you agree to provide any information requested regarding your carpool and parking practices accurately and completely.  This information will include identification and contact information for all carpool participants, including employer as well as your carpool frequency.  While not everyone in the carpool needs to be an employee of a Longwood Collective member, participation in this 6-month subsidy program is limited to employees of Longwood Collective member institutions and is one-time-only per participant.

In order to participate you must be forming a new carpool or joining an existing carpool and fill out a registration from that will be reviewed and approved by Longwood Collective.  Failure to provide requested information in an accurate and timely manner will result in your termination from the program, as well as notification of non-compliance to your employer.  Should it be determined that you have failed to provide accurate and timely information to Longwood Collective, or that you have failed to meet the requirements of the program, you expressly agree to refund Longwood Collective for all costs incurred.  These costs include, but are not limited to, any incentive benefits paid to you, plus the costs of collection, if any.  As always, you should consult your tax advisor concerning the tax consequences of any incentive.

Your e-mail address will not be made public or used for commercial purposes.  However, you may be contacted directly by Longwood Collective about your experience with commuting and transportation-related information.

As a participant in this program you hereby release and hold harmless Longwood Collective and its subsidiaries, members, directors, officers, representatives, agents and employees from all claims, losses, liabilities, damages, injuries (including the reasonable cost of defense) arising out of, or in connection with this Agreement and participation in the Carpool Program.

Thank you for registering with Longwood Collective. By submitting this form, you state you have read and agree to the statement above.