TRA Rider Registration

TRA Rider Registration
Welcome to TRA Group, Inc.! We look forward to serving you.

To sign up, please complete the application on the following pages, and hit the green "Submit" button at the end. Once we receive your application, our friendly call center staff will contact you.

In the meantime, if you have questions you can
- Give us a call at (914) 764-3533
- Send an email to Hello@my-tra.org
Please consider making a donation to TRA by going to our website at my-tra.org. Donations help us to continue to do the work that we do.

With Kind Regards,
The TRA Team
Who are you submitting this form for?
Do you have Power of Attorney for the individual you are submitting on behalf of? (You do not need Power of Attorney to complete this form on someone's behalf.)
Submitting on Behalf of Someone Else

You are welcome to complete this form on behalf of another person, but please be aware that our sign-up process requires a waiver signature from the individual being registered. Once this online form is submitted, we will contact them directly and send a paper waiver for their signature. Registration will not be considered complete until the signed waiver has been returned to us.
Name of POA

First NameLast Name
Email of POA
example@example.com
Phone Number of POA
Please enter a valid phone number.Format: (000) 000-0000.
Name of Person Submitting

First NameLast Name
Email Address of Person Submitting
example@example.com
Phone Number of Person Submitting
Please enter a valid phone number.Format: (000) 000-0000.
Relationship to Applicant
Have you already spoken with someone at TRA to begin your application? You are welcome to proceed with this form regardless.

Emergency Contact Information
Please provide us with an emergency contact. This can be a family member, friend, neighbor, clergy, or physician.
Name of Emergency Contact

First NameLast Name
Relationship to Rider
Emergency Contact Address (city and state are required)

Street Address

Street Address Line 2

CityState

Zip Code
Emergency Contact Primary Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Emergency Contact Secondary Phone Number
Leave blank if no second phone numberFormat: (000) 000-0000.

TRA Rider Rights and Responsibilities
Your Rights as a TRA Rider

• You are entitled to a safe, clean, round-trip ride, with a competent driver, arriving at your destination in a timely manner.
• Any private information given to TRA regarding your transportation needs will be regarded as confidential.

Your Responsibilities

• If you have any concerns about your rides or any questions about the service, please call TRA as soon as possible so that we can take appropriate corrective action.
• In order to ensure the safety of riders and their volunteer drivers, TRA reserves the right to deny service to individuals whose behavior in the opinion of TRA constitutes a threat to the safety of others.
• Please call at least 72 hours in advance to schedule a ride. Please provide as much notice as possible, preferably 24 hours, if you need to change or cancel a ride so that it will not be considered a no show.
• Be ready and watch for your driver at the prearranged pick-up time and place. If you live in an apartment complex, please wait in the main lobby or by the front door. Drivers are not permitted to enter your home, unless pre-arranged with the TRA Coordinator.
• Buckle Up. Keep your seat belt fastened at all times after entering a volunteer driver’s vehicle.
• Please do not smoke, eat or drink beverages in a volunteer driver’s vehicle.
• In case of threatening weather conditions, for the safety of riders and volunteer drivers, TRA reserves the right to cancel scheduled rides. TRA will call registered riders to notify them of the cancellation and the reason. Riders are responsible for canceling the appointment they will miss due to the canceled ride.
• If a caregiver or other passenger will accompany you in the volunteer’s vehicle, please be sure to notify TRA at the time you schedule your ride. For safety reasons, volunteer drivers will not transport additional passengers if they are not pre-registered with TRA or if they have not signed a waiver of liability.

NO SHOW Policy: What is a NO-SHOW?

• Your trip is considered a NO-SHOW if a driver arrives at the scheduled pick-up time and place and you are not there. TRA volunteer drivers will wait up to 15 minutes for a rider.
• Your trip is considered a NO-SHOW if you cancel when the driver arrives to pick you up for your scheduled ride, or if the volunteer is already en-route to the pick-up when you cancel.
• Please call to cancel or change your trip at least 24 hours prior—or sooner—to the scheduled pick-up time to avoid being listed as a NO-SHOW.

NOTE: If you scheduled a round trip and you NO-SHOW for first leg of the trip, TRA will automatically cancel the rest of the trip. If you still need that return trip, you must call to confirm that you need that trip.

What happens if you NO-SHOW?

• TRA will attempt to contact you by cell/home phone immediately. If you are not available, the next time you request a trip, the TRA Coordinator will review with you the NO-SHOW policy and ask for an explanation for your previous NO-SHOW and will make note of your answer.
• The second time you have a confirmed NO-SHOW, TRA again will attempt to contact you to ask for an explanation of the second NO-SHOW.
• If you have repeated problems with NO-SHOWS, your trips may be put on hold. You will be asked to call TRA 24 hours prior to your scheduled pick-up times to confirm that you will be going.

The TRA Volunteer Drivers work hard to provide rides to you and others. Please plan your trips carefully and communicate any changes to TRA as far in advance as possible to avoid loss of ride privileges.

Rider Waiver
I hereby voluntarily and of my own free will relinquish and waive the right to make any claims or bring any legal action against TRA or their officers, officials, consultants, contractors, employees and/or volunteers, for any injuries, damages, charges or expenses, including attorney’s fees which might be sustained as a result of my voluntary participation in the TRA Program. I also acknowledge that TRA reserves the right to refuse transportation service to anyone in non-compliance with the policies and procedures governing this program. TRA also reserves the right to modify the terms and conditions of this program without prior notice.

I have carefully read and understand the TRA Rider Rights and Responsibilities and fully understand its contents. I am aware that it contains a release of liability and sign it of my own free will.
Rider Name

First NameLast Name
*PLEASE NOTE* You are signing as Power of Attorney. Please use the appropriate format when signing. The format is [Rider's Name, by Your Name, POA].
Today's Date

MonthDayYear
Rider Signature

Sign using your mouse (computer) or finger (mobile device).
TRA Email
example@example.com
Thank you for your application. A member of our team will contact you shortly. We look forward to serving you!
Should be Empty:

TRA Rider Registration

Rider Registration Form

Emergency Contact Information

Please provide us with an emergency contact. This can be a family member, friend, neighbor, clergy, or physician.

Will you help us to continue our program?

TRA Rider Rights and Responsibilities

Your Rights as a TRA Rider

Your Responsibilities

NO SHOW Policy: What is a NO-SHOW?

What happens if you NO-SHOW?

Rider Waiver