Home Run - Daytime Travel Insurance Program

Please complete the following information and submit form. Staff will contact you re payment.

Registered applicant MUST be a 28-Day Pass holder, or Employer Pass holder and produce same when requested by a taxi driver.

Once registered, the application will be assigned a customer ID number and card. The ID card will be mailed back to the applicant under separate cover. However, coverage is effective 24 hours after date of registration and receipt of payment in full.

Should you have any questions, please do not hesitate to contact Customer Service at 604-488-8906.

Date	Month -- 1 2 3 4 5 6 7 8 9 10 11 12 Day -- 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Year -- 2007 2008 2009 2010
Current Pass:	28 day pass Employer pass None of the above
HomeRun to be registered in the name of
Address
City
Postal Code
Empolyer Name
Address
City
Postal Code
Telephone Number:	(work)
	(home)
Email
If applicable, HomeRun was requested and paid for by

Once you have submitted this form to West Coast Express, someone from Customer Service will contact you to complete your registration.

West Coast Express
Customer Service

•   Access Infomation
•   Parking
•   Bicycles
•   Train Amenities
•   Group Travel
•   Service Programs
  • Home Run
  • Circle Tours
  • Train-Bus