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By checking this box and submitting, I provide my electronic signature and agree that Senior Reliance Group LLC and the Partner(s) identified to me at the time of submission may contact me at the telephone number and email address I provided about the products or services I requested, including by call, text message, or email. If stated for this form, contact may use an automatic telephone dialing system, prerecorded or artificial voice, or other automated technology. Consent is not a condition of purchasing any property, goods, or services. Message and data rates may apply; message frequency varies. I may revoke consent at any time by any reasonable method, including replying STOP to a text, asking not to be called again, or contacting [email protected] or (940) 629-2836. I confirm that I am the subscriber or customary user of the number provided and am at least 18 years old.