Bicycle Permit

You may complete this application online, print it out, and mail it to us with $5.00 payment to Customer Service Department, MTA Metro-North Railroad, 89 East 42nd Street, New York, New York 10017.

CONDITIONS

I hereby agree to assume all liability for any damage or injury to myself, other persons, or property resulting from, or in connection with, the carriage of my bicycle on MTA Metro-North Railroad and Long Island Rail Road trains, or at any facility used in connection with Metro-North and Long Island Rail Road rail services. Having read and understood the attached bicycle access program regulations, I agree to all the terms and conditions governing the use of the bicycle permit. I understand that train crews have the authority to bar a bicycle from a train if, in their judgement, it cannot be carried safely, ad that failure to comply with the regulations could result in the revocation of my bicycle permit.


Signature of Applicant	Date of Application

Signature of Parent or Guardian (if applicant is a minor)

Please complete application and mail with a $5.00 registration fee (check payable to Metro-North) to : Customer Service Department, MTA Metro-North Railroad, 89 East 42nd Street, New York, NY 10017.

For further information call 511.

I plan to use my own permit between __________ and ___________ stations.

Weekdays Weekends

All lost permits require a $5.00 fee for renewal.
Regulations and restrictions apply, and are listed on the Bicycle Permit.
Please be sure to read them when you receive your permit.

For more information, call (212) 532-4900

PERMIT NO.
PLEASE PRINT or TYPE Mr. Mrs. Ms. (Check one) Sex : Male Female
First Name, MI, Last Name:
Date of Birth:
Mailing Address:
City, State, ZIP:
Home Telephone: