Text Bridge Enrollment Form
This page shows the enrollment information and consent language used for Text Bridge, a communications relay service operated by K Tel LLC.
Sample Paper Enrollment Form
Subscriber Information
Name: ________________________________________________
Mailing Address: ______________________________________
City: ______________________ State: ______ Zip: _________
Landline Telephone Number: ____________________________
Alternate Contact Number, if any: _______________________
Plan Selection
☐ Monthly Plan — $15.00 per month
☐ Annual Plan — $131.88 per year, averaging $10.99 per month when paid yearly
Consent to Receive Communications
By signing below, I consent to participate in the Text Bridge service operated by K Tel LLC. I understand that Text Bridge allows SMS messages to be exchanged through my assigned Text Bridge telephone number and that service-related SMS communications may be sent through the Text Bridge system.
Message frequency varies based on use of the service. Message and data rates may apply. I understand that I may cancel Text Bridge service at any time by contacting K Tel LLC.
Subscriber Signature: _________________________________
Date: __________________
Verbal Enrollment Script
When enrollment is completed by telephone, K Tel LLC uses the following consent script:
Before activating your Text Bridge account, I need your permission to enroll you in the service. By enrolling in Text Bridge, you agree to receive service-related SMS communications through the Text Bridge system. Message frequency varies based on your usage. Message and data rates may apply. You may cancel your Text Bridge service at any time by contacting K Tel LLC. Do you agree to enroll in the Text Bridge service and receive these communications?
How Text Bridge Messages Work
Each subscriber receives a dedicated telephone number. Mobile phone users may voluntarily send SMS messages to the subscriber's assigned Text Bridge number. Text Bridge converts incoming SMS messages into voice prompts that the subscriber can hear by telephone.
Subscribers may dictate replies by telephone. Text Bridge converts the spoken reply into SMS text and sends it back to the original sender after the subscriber approves the reply.
No Marketing or Bulk Messaging
Text Bridge does not send unsolicited messages, promotional messages, marketing messages, or bulk messaging. Messages are conversational communications between subscribers and their family members, friends, customers, and other contacts.
Contact
K Tel LLC
14351 Hoxie Rd
Addison, MI 49220
Email: support@ktel-llc.com