Text Messaging Consent Form

Dear Valued Customer,

We appreciate your business and want to ensure that we provide you with the best possible service. In order to enhance our communication with you, we are seeking your permission to send text messages to your mobile phone number. These messages may include important updates about your insurance policies, transactions initiated by you, or marketing messages regarding the products and services offered by or through Harbor Star Insurance, LLC.

By signing this consent form, you agree to the following terms and conditions:

  1. Consent for Text Messages: You give consent to Harbor Star Insurance, LLC to send text messages, including marketing/promotional messages and text messages made with an Auto-dialer to your mobile phone number. Consent for text messages is not a condition for doing business with Harbor Star Insurance, LLC. If you do not consent to receiving text messages from Harbor Star Insurance, LLC we will contact you by other available means of communication.
  2. Ownership of Mobile Phone Number: You confirm that you are the owner or an authorized user of the mobile phone number provided below. If at any point you are no longer the owner or authorized user of the mobile phone number, you agree to notify us immediately.
  3. Message and Data Charges: You acknowledge that you are solely responsible for any message and data charges associated with the text messages received from Harbor Star Insurance, LLC.
  4. Understanding of Terms and Conditions: You confirm that you have received, read, and understood the text messaging terms and conditions provided by Harbor Star Insurance, LLC. By signing this consent form, you agree to comply with the terms and conditions outlined in those documents.
  5. Confirmation of Consent: If you sign this consent form, you will receive an initial text message to the mobile phone number provided below. Please respond to this message with a “yes” or “no” to confirm or decline your consent. If you choose not to receive text messages from Harbor Star Insurance, LLC or do not wish to comply with the terms and conditions, please do not sign this consent form.

 

Please provide the following information:

Name(Required)
Home Address(Required)

 

SMS/Text Messaging Terms & Conditions
Please read these SMS/Text Messaging Terms & Conditions carefully. By completing the SMS/Text Messaging Opt-In Form, you expressly consent to receive non-marketing and marketing text messages from Harbor Star Insurance, LLC “Harbor Star Insurance, LLC”, including text messages made with an Auto-dialer, at the mobile phone number(s) you provide. You may opt out of these communications at any time by replying STOP to any text message from Harbor Star Insurance, LLC or by otherwise contacting Harbor Star Insurance, LLC as indicated below. You can receive help at any time by replying HELP to any text message from Harbor Star Insurance, LLC or by otherwise contacting Harbor Star Insurance, LLC as indicated below. Consent to receive non-marketing and marketing text messages is not required to purchase any products or services from Harbor Star Insurance, LLC. Messaging and data rates may apply. By completing the SMS/Text Messaging Opt-In Form, you also accept and agree to be bound by these SMS/Text Messaging Terms & Conditions and any other applicable terms and agreements related to your use of Harbor Star Insurance, LLC services.

Program Description
Harbor Star Insurance, LLC offers its text messaging program whereby Harbor Star Insurance, LLC, will text message you to provide you with information concerning your account activity with Harbor Star Insurance, LLC and other Harbor Star Insurance, LLC products, services, and promotions (all of the foregoing the “Harbor Star Insurance, LLC Program”). Harbor Star Insurance, LLC may from time to time, use a standard or an automatic telephone dialing system (“Auto-dialer”) to deliver text messages to you under the Harbor Star Insurance, LLC Program. You agree that you will not use the Harbor Star Insurance, LLC Program for any illegal or unlawful purposes. No coverage may be bound or amended via text message or the Harbor Star Insurance, LLC Program.

Message Frequency
Under the Harbor Star Insurance, LLC Program, the number of Harbor Star Insurance, LLC text messages that you receive may vary depending on your account activity and your communication with Harbor Star Insurance, LLC.

Cost
Harbor Star Insurance, LLC does not impose a separate fee for sending Harbor Star Insurance, LLC text messages under the Harbor Star Insurance, LLC Program. However, standard message and data rates may apply to each text message sent or received in connection with the Harbor Star Insurance, LLC Program, as provided in your mobile telephone service rate plan. Please contact your mobile telephone carrier for pricing plans and information.

Supported Carriers; Interruption
The Harbor Star Insurance, LLC Program should be available through your equipment or mobile device when the equipment or device is within the operating range of your wireless service provider. The Harbor Star Insurance, LLC Program may not be available on all equipment/mobile devices, or through all wireless carriers, and not all functionalities of the Harbor Star Insurance, LLC Program are available on all equipment/mobile devices, or through all wireless carriers. Harbor Star Insurance, LLC may, from time to time, at its discretion and without notice to you, limit the carriers that support the Harbor Star Insurance, LLC Program. Certain other carriers may not support the Harbor Star Insurance, LLC Program. Delivery of information and content to your equipment/mobile device may fail due to a variety of circumstances or conditions. The Harbor Star Insurance, LLC Program is subject to transmission limitation or interruption. You understand and acknowledge that mobile network services are outside of Harbor Star Insurance, LLC’s control, and Harbor Star Insurance, LLC is not responsible or liable for issues arising therefrom, or the failure thereof, including, without limitation, technical, hardware, software, electronic, network, telephone or other communications malfunctions, errors or failures of any kind, errors in transmission, traffic congestion, lost or unavailable network connections, telephone connections, wireless phone connections, website, Internet, or ISP availability, unauthorized human intervention, traffic congestion, incomplete or inaccurate capture of entry information (regardless of cause) of failed, incomplete, garbled, jumbled or delayed transmissions which may limit or restrict your ability to receive or send a message, including any injury or damage to your or any other person’s equipment/wireless device relating to or resulting from participating in or using the Harbor Star Insurance, LLC Program. If the Harbor Star Insurance, LLC Program is not available within your intended location, you agree that your sole remedy is to cease using Harbor Star Insurance, LLC Program.

How to Opt-In
To opt-in to receive text messages from Harbor Star Insurance, LLC under the Harbor Star Insurance, LLC Program, complete the SMS/Text Messaging Opt-In Form and submit it to Harbor Star Insurance, LLC, Harbor Star Insurance, LLC will then send you a text message asking you to confirm your enrollment in the Harbor Star Insurance, LLC Program.

How to Opt-Out
To stop receiving text messages from Harbor Star Insurance, LLC, reply STOP or text STOP to the ten-digit long code from which the text messages are being sent. You will then receive confirmation of your opt-out of the Harbor Star Insurance, LLC text messaging program. You may also opt out by providing written notice to Harbor Star Insurance, LLC at 25418 Marion Avenue Suite 2, Punta Gorda, FL 33950, by emailing Harbor Star Insurance, LLC at [email protected], or by calling Harbor Star Insurance, LLC at 941-655-8345.

Your Mobile Telephone Number
You represent that you are the account holder for the mobile telephone number(s) that you provide or that you have the account holder’s permission to enter the mobile telephone number(s) that you provide and that you will not initiate messages to the mobile phone of any other person or entity. You agree to maintain accurate, complete, and up-to-date information with Harbor Star Insurance, LLC regarding your use of
the Harbor Star Insurance, LLC Program, including, without limitation, notifying Harbor Star Insurance, LLC in writing immediately if you change, or cease being the regular user of, your mobile telephone number. You agree to indemnify Harbor Star Insurance, LLC in full for all claims, expenses, damages, and costs, including reasonable attorneys’ fees, related to or cause in whole or in part by your failure to notify Harbor Star Insurance, LLC if you change your telephone number, or cease being the regular user of, including, but not limited to, all claims, expenses, damages, and costs related to or arising under the Telephone Consumer Protection Act, 47 U.S.C. § 227 et seq.

Privacy
Harbor Star Insurance, LLC’s privacy policy may be accessed at the following link: [LINK].

Support/Help
To request more information, text HELP to the ten-digit long code from which the text messages are being sent. You may also receive help by providing written notice to Harbor Star Insurance, LLC at 25418 Marion Avenue Suite 2, Punta Gorda, FL 33950, by emailing Harbor Star Insurance, LLC at [email protected], or by calling Harbor Star Insurance, LLC at 941-655-8345.

Eligibility
To receive Harbor Star Insurance, LLC text messages or enroll in the Harbor Star Insurance, LLC Program, you must be a resident of the United States, eighteen (18) years of age or older, authorized to enroll the mobile phone number in the Harbor Star Insurance, LLC Program, and authorized to incur any mobile message or data charges incurred by participating. Harbor Star Insurance, LLC reserves the right to require you to prove the foregoing to participate in the Harbor Star Insurance, LLC Program.

Changes to These SMS/Text Messaging Terms & Conditions
Harbor Star Insurance, LLC may revise, modify, or amend these Harbor Star Insurance, LLC NAME SMS/Text Messaging Terms & Conditions at any time. Any such revision, modification, or amendment shall take effect when it is posted to the Harbor Star Insurance, LLC website. You agree to review these Harbor Star Insurance, LLC SMS/Text Messaging Terms & Conditions periodically to ensure that you are aware of any changes. Your continued consent to receive Harbor Star Insurance, LLC NAME text messages will indicate your acceptance of those changes.

Amendment: Termination of Text Messaging
Harbor Star Insurance, LLC may suspend or terminate your receipt of Harbor Star Insurance, LLC text messages if Harbor Star Insurance, LLC believes you are in breach of these Harbor Star Insurance, LLC SMS/Text Messaging Terms & Conditions. Your receipt of Harbor Star Insurance, LLC text messages is also subject to termination in the event that your mobile telephone service terminates or lapses. Harbor Star Insurance, LLC reserves the right to modify or discontinue, temporarily or permanently, all or any part of Harbor Star Insurance, LLC text messages and the Harbor Star Insurance, LLC Program, for any reason, with or without notice to you.

Release; No Warranties; Limitation of Liability
By participating in the Harbor Star Insurance, LLC Program, you agree to release and hold harmless Harbor Star Insurance, LLC and its representatives, agents, successors, assigns, employees, officers, and directors, from any and all liability, for loss, harm, damage, injury, attorneys’ fees, cost or expense whatsoever including without limitation, property damage, personal injury and death that may occur in connection with the Harbor Star Insurance, LLC, or your use thereof, and for any claims, matters, or disputes based on violation of law or infringement or violation of any rights of any persons or entity, including, without limitation, violation of publicity rights, defamation, or invasion of privacy.
THE Harbor Star Insurance, LLC PROGRAM IS PROVIDED AS IS, WHERE IS, AND WITH ALL FAULTS AND WITHOUT WARRANTY OF ANY KIND, EITHER EXPRESS, IMPLIED, WRITTEN, ORAL, OR ARISING UNDER CUSTOM OR TRADE. Harbor Star Insurance, LLC DISCLAIMS ALL WARRANTIES, INCLUDING, BUT NOT LIMITED TO, ANY IMPLIED WARRANTIES OF MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, AND NON-INFRINGEMENT.

In no event shall Harbor Star Insurance, LLC be liable to you, or to any third party, for any losses or damages whatsoever arising out of or resulting from the Harbor Star Insurance, LLC Program, or your use thereof, regardless of the theory of recovery, including, without limitation, direct, indirect, consequential, incidental or special damages, lost profits, punitive damages, attorneys’ fees or any damages arising out of or resulting from a statutory or regulatory violation, negligence, gross negligence, strict liability, tortious conduct, willful misconduct or fraud, breach of contract, or breach of warranty. To the extent this damage waiver is contrary to applicable law, your or any third party’s maximum recovery for any losses or damages whatsoever arising out of or resulting from the Harbor Star Insurance, LLC Program, or your use thereof, regardless of the theory of recovery, is $10.00.

Arbitration/Class Action Waiver
ALL DISPUTES, MATTERS, OR CLAIMS BETWEEN YOU AND Harbor Star Insurance, LLC ARISING OUT OF OR RELATING IN ANY WAY TO THESE SMS/TEXT MESSAGING TERMS & CONDITIONS, ANY TEXT MESSAGES BETWEEN YOU AND Harbor Star Insurance, LLC OR ANYONE ACTING ON YOUR OR Harbor Star Insurance, LLC’s BEHALF, OR THE Harbor Star Insurance, LLC PROGRAM, REGARDLESS OF THE LIABILITY OR RECOVERY, MUST BE RESOLVED SOLELY BY ARBITRATION CONDUCTED EXPEDITIOUSLY IN ACCORDANCE WITH THE AMERICAN ARBITRATION ASSOCIATION CONSUMER ARBITRATION RULES (“AAA RULES”) BY A SOLE ARBITRATOR SELECTED BY THE PARTIES TO THE DISPUTE FROM THE NATIONAL [FILL IN YOUR PREFERRED LOATION] PANEL OF ARBITRATORS. ALL DISPUTES, MATTERS, OR CLAIMS BETWEEN YOU AND Harbor Star Insurance, LLC INCLUDE, WITHOUT LIMITATION, ANY ACTUAL OR ALLEGED STAUTTORY OR REGULATORY VIOLATION, EQUITABLE CLAIM, NEGLIGENCES, GROSS NEGLIGENCE, STRICT LIABILITY, TORTIOUS CONDUCT, WILLFULF MISCONDUCT OR FRAUD, BREACH OF CONTRACT, BREACH OF WARRANTY, AS WELL AS ALL DISPUTES, MATTERS, OR CLAIMS ARISING OUT OF OR RELATING IN ANY WAY TO THE ARBITRATION/CLASS ACTION WAIVER PROVISION OR THE RELEASE; NO WARRANTIES; LIMITATION OF LIABILITY PROVISION.

 

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