Walk ‘n Work Consent Form Demo YOUR DETAILSName*Address*Email* Mobile Phone Number*Business Name*Business Address*Emergency Contact Person*Mobile*Do you have a pre-existing condition that might impact your ability to walk?*YesNoDetailsAre you allergic to sunscreen or asprin?*YesNoDetailsWould you like our walk occasionally shared on social media?*Yes, happy to participateNo, I don’t want to participatePlease provide your business profile so that I can tag your business in any photos taken. FacebookInstagramTwitterLinkedInWhat do you most hope to get from doing the walk/s?*The talks during our walks will always remain confidential. However, if I feel our discussions indicate that you may be of harm to yourself or others I am obliged to share this information with appropriate authorities to ensure the safety of yourself and others.CONSENTDo you accept the terms below?* I acknowledge that I have chosen to participate in a Walk ‘n Talk work and am responsible for my participation. I also acknowledge that if I am at risk of harm to myself or others, information shared on my walk may be disclosed to relevant parties. I acknowledge that Leanne Faulkner does not provide financial advice and I must always seek the advice of a trained finance professional when making financial decisions. Date* Date Format: MM slash DD slash YYYY LEARNING MORE ABOUT YOU (CONFIDENTIALLY!)What are your strengths as a business owner?*What is your three year goal? Feel free to list more than one.*Do you have a 10 year goal for your business? If yes, what is it?What aspects of your business are most likely to keep you awake at night?*If there were a “business genie” who could grant you any three wishes for your business (without conditions), what would you ask for?*PhoneThis field is for validation purposes and should be left unchanged. Submit This iframe contains the logic required to handle Ajax powered Gravity Forms.