Clone of Walk & Talk Series Registration

Your Name*

First NameLast Name

Your Partner's Name*

First NameLast Name

Your Age*

18-2526-3536 -45Over 45

Your Partner's Age*

18-2526-3536 -45Over 45

Your Number*

Your Partner's Number*

Your E-mail*

example@example.com

Your Partner's E-mail*

example@example.com

One Emergency Contact's Name*

First NameLast Name

Relationship*

Phone Number*

RSVP AGREEMENT, LIABILITY & PHOTO/VIDEO RELEASE (2026)

By submitting this RSVP, I voluntarily assume all risks associated with participating in any Walk & Talk Series events hosted by The Teneka B Brand Five-Star Coaching Company during the calendar year 2026, including light physical activity in public spaces. I accept full responsibility for my own safety and the supervision and well-being of any accompanying children. I hereby release and hold harmless The Teneka B Brand Five-Star Coaching Company, its owner, representatives, and affiliates from any and all liability, claims, or damages arising from participation. I understand this event is not a fitness class, medical service, therapy session, or childcare service, and participation is at my own risk.

Photo/Video Release. I grant The Teneka B Brand Five-Star Coaching Company permission to photograph and/or record me and my child(ren) during Walk & Talk events and to use such images, audio, or video for marketing, promotional, educational, and informational purposes across digital and print platforms without compensation. I understand that I may notify the host in writing if I do not wish to be photographed or recorded. Notify through email ijsdcblog@gmail.com.

By registering, I also consent to receive email and text communications from The Tanika B Brand – Five-Star Coaching Company related to events and coaching services, with the option to opt out at any time.

This waiver applies to all Walk & Talk Series events attended during the 2026 calendar year.

Your Signature 》》》BY SIGNING AND SUBMITTING THIS REGISTRATION BELOW, I AM AGREEING TO THE RSVP AGREEMENT, LIABILITY & PHOTO/VIDEO RELEASE (026) CLAUSE LISTED ABOVE AND I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Your Partner's Signature 》》》BY SIGNING AND SUBMITTING THIS REGISTRATION BELOW, I AM AGREEING TO THE RSVP AGREEMENT, LIABILITY & PHOTO/VIDEO RELEASE (026) CLAUSE LISTED ABOVE AND I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Date

Event selection *

Love in Motion: A Couples Walk & Talk Experience 1-14-2026Valentine’s Day doesn’t have to mean crowded restaurants or surface-level conversation. Love in Motion is an intentional couples experience designed to help partners reconnect, communicate, and be present with one another in a calm, supportive environment.

$40.00

Total

$0.00

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

Registration Form