First Name *

Last Name *

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Please review and sign the following waiver:

Any and all aspects of the course are undertaken voluntarily on your part. The course is not meant as therapy or as a   replacement for any other professional service that you would engage for your physical or mental health. The waiver is your acknowledgement that the Personal Transformation and Courage  Institute is released from any liability related to your participation in the course.

The undersigned knowingly releases and holds harmless the Personal Transformation and Courage Institute and its agents from any and all claims, suits, proceedings, costs, losses, expenses, damages, and liabilities, including but not limited to attorney’s fees and court costs, caused by and arising out of, or in connection with his/her participating in this course.

E-Signature *

Tuition for this course is $600

Refund Policy: Cancellations that are made one week prior to the starting date of the course are eligible for a refund. After that date, a refund is available if we are able to fill your spot with another course participant. A waiting list will be maintained for those who are interested if no registration spots are available. Refunds will be issued in the same form as original payment.

Please indicate how you will be paying for this course:

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