The Intimacy and Attraction Workshop® ($5 off)

$54.00 – $100.00

SKU: 10 Categories: Workshop Waiver, Workshops

Consent Form
Please fill out the fields below. We promise it's not long, we just need to get some basic information. Once complete, click the add-to-cart button.
Workshop/Training with Joanna Intara

Workshop Agreement:
My decision to participate in this workshop/training is a personal decision. No one has made any promises or warranties as to the results or benefits I will receive or as to any specific results I will realize from my participation in this workshop/training. I am committed to participating fully in this workshop/training for the full training. I understand that this workshop/training is not therapy or psychological counseling and is not a substitute for the treatments or services ordinarily provided by health care professionals for physiological or psychological complaints. If I desire therapy or psychological counseling, I will seek it from a licensed provider. I am well, physically and emotionally and commit to being responsible for my own well-being during the course of this workshop. I understand that this workshop/training is for my personal benefit only and may not be appropriate for others. I understand and agree that successful completion of a workshop does not constitute professional training and does not entitle me to teach, lead, coach or otherwise use this material with others in any way. I understand that all materials used in this course are confidential and proprietary in nature and other than for my own personal use, I will have no future right to use these materials or processes in any way.
I assume all risk associated with participating in this workshop and release the workshop leaders, Joanna Intara, their affiliates, employees, and agents from, and shall defend, and indemnify, and hold them harmless from and against, all liabilities, claims, actions, losses, causes of action, and costs in any way arising out of my participation in the Program. I release the workshop location, workshop teaching assistants, and Joanna Intara from any liability for injuries due to their negligence occurring now or in the future, during or after my participation in this workshop.
I understand that I am responsible for notifying a staff person if I choose to leave the workshop without completing. I acknowledge and agree that the workshop, as well as my participation in the workshop, can be terminated at the discretion of Joanna Intara for any reason at any time. If I withdraw from the workshop for any reason whatsoever, no part of the workshop fee shall be refunded and any unpaid portion thereof shall become due and payable immediately from me to the workshop leader.
I have read and understand this agreement fully and intend to be legally bound by it. My signature below constitutes my acceptance of the conditions expressed in this agreement.

Participant’s Name
*First Name

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*Last Name

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Participant’s Date of Birth
I certify that I am 18 years of age or older
*Participant Signature:

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Email Address
Email address

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Confirm Email address

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Workshop Agreement:
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary. $
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Individual ($5 off) quantity	Individual ($5 off)	$54.00
Couple ($10 off) quantity	Couple ($10 off)	$100.00

The Intimacy and Attraction Workshop® ($5 off)

Consent Form

Workshop/Training with Joanna Intara

Workshop Agreement:

Participant’s Name

Participant’s Date of Birth

Email Address

Workshop Agreement: