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Earthquake Update Request Questionnaire

[contact-form][contact-field label=”Name” type=”name” required=”1″ /][contact-field label=”Email” type=”email” required=”1″ /][contact-field label=”Website” type=”url” /][contact-field label=”Comment” type=”textarea” required=”1″ /][/contact-form]

Please answer these questions and fill out request form for receiving my email  updates.

If you are having problems with this link working it could be a browser compatibility issue.  We tested it for Windows Explorer, Firefox and Google Chrome.. and it worked.  So if the link is not working for you, please just email me and I will send you a questionnaire and sign you up.
My apologies for any problems you might encounter.. charking.

Your name..

Where do you live?

1. Are you a sensitive or potential sensitive?

  1. Is this for private or business use?

3 .You agree not to  repost anything I send out or make any predictions based on what I have written in my name?  * Such as “ charlotte said etc…”

  1. I am not a medical doctor, I can only share what has worked for me and many others . You agree to accept full responsibility for your actions or reactions that may happen based on your own physical condition. Remember you may be right but you could be dead wrong, so don’t ignore symptoms that are severe or do not go away within a reasonable amount of time. Check with your doctor if you have other medical conditions.

You agree not to copy in any media form any portion of my updates without clearing it with me first. The updates are the sole property of Charlotte King and may not be duplicated. It is fine for you to share them with close friends and immediate family. Please also ask them not to repost the information.  This includes “Social Media”

Charlotte King 

503-999-5745 * anytime *

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