Table Talk For Adults Ages 18+ Table Talk Registration (Ages 18 and up) (Maximum registrations 16) Participant Name* First Last Age Gender Male Female Prefer not to answer Preference Straight LGTBQ Prefer not to answer PhoneCity fromPlease list your Email Address:* Emergency Contact First Last Emergency Contact PhoneMeal Choice Ham Sandwich Turkey Sandwhich Veggie Wrap Table Talk Registration Price: *After the event, we would like to follow up with you to find out how your experience was. Your input is extremely important and will help us plan future events. We would also like to provide names and phone numbers of individuals that you meet at Table talk that share common interests with you. Is it okay to share your phone number with another individual that you matched well with at Table Talk?*After the event, we would like to follow up with you to find out how your experience was. Your input is extremely important and will help us plan future events. We would also like to provide names and phone numbers of individuals that you meet at Table talk that share common interests with you. Is it okay to share your phone number with another individual that you matched well with at Table Talk? Yes I acknowledge that Spectrum Autism Support Group, Inc (Spectrum) and Gkasts has the right to photograph, videotape, and/or create other audiovisual materials of my participation in activities of Spectrum’s program Table Talk, and that Spectrum and Gkasts has the royalty-free rights to use the Audio-Visual Materials of me in public relations, marketing and promotional activities and materials in any medium whatsoever including, but not limited to, videotapes, pamphlets, and brochures including use in print, radio, television, social media and the internet.I acknowledge that Spectrum Autism Support Group, Inc (Spectrum) and Gkasts has the right to photograph, videotape, and/or create other audiovisual materials of my participation in activities of Spectrum’s program Table Talk, and that Spectrum and Gkasts has the royalty-free rights to use the Audio-Visual Materials of me in public relations, marketing and promotional activities and materials in any medium whatsoever including, but not limited to, videotapes, pamphlets, and brochures including use in print, radio, television, social media and the internet. Yes
