Book Readers Focus Group Contract & Consent Form
Thank you for choosing to be apart of Elisha Lili Davis's Reader Focus Group for her new Book: 
  • You will receive a free copy of the book when it is officially released because of your support and choosing to be about of this reader focus group.
  • Book Publish Release Date is June 21st (Lili's Birthday).
  • Book Launch Event is June 17, 2023 in Oakland, CA from 5pm to 10pm.
$25 Discount 
  • Already Bought Your Ticket: If you already bought your ticket to the book launch event, you will receive a $25 refund since a copy of the book comes with your ticket.
  • Have Not Bought Your Ticket: If you have not bought your ticket to the book launch event yet, you will receive a $25 discount code since a copy of the book comes with your ticket.
Sign in to Google to save your progress. Learn more
First Name
*
Last Name
*
Email Address (The Best One You Check The Most)
Providing your phone number means that you consent to receive email messages from us as a subscriber.
*
Phone Number (Mobile Cell)
Providing your phone number means that you consent to receive text message from us as a subscriber.
*
State You Live In *
How Would You Describe Your Gender Identity?
We are asking for this information because we want to be respectful, to understand how you prefer to be addressed when it comes to your gender identify, and for data analytics purposes in business to know more about our audience we are reaching.

(Only Select One Box Please)
*
Required
Were You An Athlete?

(Only Select ONE Box Please)
*
Required
If Yes As An Athlete, What Sport(s) Did You Compete In Seriously?

OR 

If No As A Non-Athlete, Type N/A

(Only Select ONE Box Please)
*
If Yes As An Athlete, What Was The Highest Level You Competed At? (Example: High School, 2-Year Juco/Community College, 4-Year University/College, Overseas, Or Pro's?

OR 

If No As A Non-Athlete, Type N/A

(Only Select ONE Box Please)
*
BOOK NON-COMPETE AGREEMENT:  

I consent because I read, I understand, I acknowledge, and I agree I am consenting that I WILL NOT STEAL, COPYRIGHT, PLAGIARIZE, AND/OR SELL THE BOOK MANUSCRIPT, IDEA, CONCEPT OR ANYTHING DISCUSSED WITH THE AUTHOR.

(Only Select One Box Please)
*
Required
BOOK NON-DISCLOSURE/CONFIDENTIALITY AGREEMENT: 

I consent because I read, I understand, I acknowledge, and I agree I am consenting to NEVER TALK ABOUT OR SHARE THIS BOOK MANUSCRIPT, IDEA, OR CONCEPT OR SHARE ANY INFORMATION WE DISCUSS ABOUT THE BOOK with any person, platform, affiliate, assignor, association, organization, or corporation.

(Only Select One Box Please)
*
Required
BOOK NON-DISCLOSURE/CONFIDENTIALITY AGREEMENT:  

I consent because I read, I understand, I acknowledge, and I agree I am consenting that I CAN BE FINED & SUED if I break the NON-DISCLOSURE/CONFIDENTIALITY AGREEMENT.

(Only Select One Box Please)
*
Required
BOOK REVIEW AGREEMENT:  

I consent because I read, I understand, I acknowledge, and I agree I am consenting that I WILL SUBMIT AN HONEST REVIEW (GIVE MY FEEDBACK) ABOUT THE BOOK TO SUPPORT AND HELP THE BOOK GET GOOD ENGAGEMENT TO START NEEDED CONVERSATIONS ABOUT THE TOPIC when the book is officially published and released?

(Only Select One Box Please)
*
Required
I consent because I read, I understand, I acknowledge, and I agree I am consenting to RECEIVE CONTACT VIA EMAIL FOR DOCUMENTATION PURPOSES to confirm it was in fact me who filled out, completed, and submitted this contract (contractual agreement) and consent form with my electronic signature.

(Only Select One Box Please)
*
Required
I consent because I read, I understand, I acknowledge, and I agree I am consenting that BY TYPING MY FIRST NAME AND LAST NAME BELOW AS IT SERVES AS CONFIRMATION for the contract (contractual agreement) and consent form with my electronic signature.

(Only Select One Box Please)
*
Required
I consent because I read, I understand, I acknowledge, and I agree I am consenting that I WILL TYPE MY FIRST NAME AND LAST NAME BELOW AS IT SERVES AS CONFIRMATION for the contract (contractual agreement) and consent form with my electronic signature.

(Only Type Your First Name & Last Name Please)
*
I consent because I read, I understand, I acknowledge, and I agree I am consenting that I WILL TYPE TODAY'S MONTH/DAY/YEAR BELOW AS IT SERVES AS CONFIRMATION for the contract (contractual agreement) and consent form with my electronic signature.

(Only Type Month/Day/Year Please)
*
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Elisha Lili Davis. Report Abuse