December 2021 Book Club Registration

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for registering for the book club discussion of THE GIFTS OF IMPERFECTION by Brené Brown! We are so excited to have you and look forward to getting to know you!

To participate in the conversation hosted by Tiffany Maurer of A Texan's Fitness, please complete the form below. After payment has been received, the Zoom information will be emailed to you (add atexansfitness@gmail.com to your contact list to ensure the email is received).

This meeting will be on Wednesday, December 29, 2021 at 7pm CST (8pm EST/5pm PST)

Email *

Full Name *

Where you live (City/State/Country/Timezone) *

Phone Number

Please confirm you agree with EACH of the following by checking the box to the left. *

I agree to participate in the discussion (which includes reading the book and participating in the Zoom meeting with video on).

I understand no refunds will be granted once the commitment has been made. Exceptions might be granted for extenuating circumstances, based on the Host’s discretion.

I understand and agree that I am fully responsible for my physical, mental and emotional well-being, including my choices and decisions. I am aware that I can choose to exit the conversation at any time.

I agree to keep the confidentiality of all the participants and will not record the Zoom meetings.

I understand that exceptions to confidentiality relate to circumstances such as intent to seriously harm someone, child abuse, thoughts of suicide etc. Otherwise, all remaining information is kept confidential.

I agree to respect the opinions of the other participants.

By registering for this event, I understand I will be signed up to receive A Texan's Fitness newsletter and I can unsubscribe at anytime.

Required

Payment Options ($5) *

Venmo (@Tiffany-Maurer)

Paypal (paypal.me/atexansfitness)

First Name *

Last Name *

Date *

YYYY

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms