Server Registration

Complete and submit this form to enroll into the SafeRide Server Commission Program. Thank you for your time and support!

First Name *

Last Name *

Bar/Restaurant Name Where You Work *

City or location

Your Cell Phone Number *

Email Address

Choose the payment platform you prefer to receive your commissions for completed ride referrals. *

Enter your preferred payment platform ID *

Terms and Conditions *

You consent to receive communications from SafeRide America by SMS text messages. Standard message and data rates apply. You can reply STOP to cancel and opt out at anytime.

Commissions-$5 for new SafeRide users, $1 for existing SafeRide users, $20 for first new SafeRide user, Double commission for first 30 days

I agree to save the following contact information to my cell phone contacts now. The SafeRide text only number is 833-229-2116

Please sign *

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