PARTICIPATION AGREEMENT

Full Name: Full Name  Gender: Gender   

Full Address:Street Address   Address Line 2   
City   State   Zip   
Email   
SSN: Social Security Number     Date of Birth:Date of Birth    
Phone Number: Phone Number   

Emergency Contact Name: Full Name of Emergency Contact    
Phone Number: Phone Number    Relationship: Relationship   


The Pain Relief Center, Inc. Master Bodywork Workshop and Apprenticeship Program (herein referred to as the Program) and   Full Name      have willingly entered into this agreement on   Date   for the    Please SelectWorkshopApprenticeshipWorkshop and Apprenticeship  training as required for licensing as a Massage Therapist in the State of Hawaii.

The Workshop phase consists of a 12-week, 170-hour academic program which, when successfully completed, will qualify the applicant to apply for the apprenticeship program.

The Workshop curriculum includes:


The Apprenticeship phase is a 550-hour practical program and must be completed within a minimum of 6 months to a maximum of one (1) year from the date the apprenticeship permit is issued. Upon successful completion of the program requirements, the apprentice will be qualified to submit the application, supporting documents, and non-refundable application fees ($50) to the Hawaii State Board of Massage Therapy for approval to take the Hawaii State Licensing exam. The application, documents and fees for licensure must be submitted no less than forty-five (45) days before the scheduled test dates (March, June, September and December). 

The Apprenticeship curriculum includes:


Either phase may be terminated at any time, by either parties, upon written notice. Refunds will be based on this schedule:

• 80% refund if terminated 60-90 days prior to start of class
• 50% refund if terminated 30-60 days prior to start of class
• No Refunds are available if terminated 30 days prior to the start of class.

As an applicant to the Program I agree to the following:

Initials   I understand that while the State of Hawaii will accept the educational and clinic hours provided by the Program, other states may not. This may affect my ability to obtain licensure if I move outside the State of Hawaii.

Initials   I understand that the total tuition for the full Program is $4500. 

1. The Workshop tuition is $2950
2. The Apprenticeship tuition is $1550.

Initials   I understand that the $50 fee that accompanied my application is a non-refundable fee and that a deposit of $250 must be made upon signing this agreement in order to secure my place in the Program. All payments are made to The Pain Relief Center.

Initials   I understand that I will receive a 10% discount on the total tuition if it is paid in full prior to or on the first day of class. Payment plans are available on request (plus 5% interest per year). Tuition may be paid by cash, check (a $45 service fee will be charged if check is returned, tuition may be resubmitted in any form other than another personal check), credit card, Venmo, cashiers check or money order.

Initials   I agree to acquire all the required texts prior to the Workshop and Apprenticeship start dates.

Initials   I understand that I will be able to miss up to 4 hours of classroom instruction but, ultimately, it is my responsibility to attend all training. Any additional missed class hours will be documented and arrangements must be made with the instructor for make-up hours, which may incur fees not included in the tuition.

Initials  I agree to participate fully, keep accurate records, complete and submit all required paperwork, homework & tests, and to abide by any and all rules and procedures established by the instructors and the Program.

Initials  I understand that in order to qualify for the Hawaii State Licensing Exam I will be required to take and pass an infant and adult cardiopulmonary resuscitation (CPR) training course issued by the American Red Cross or American Heart Association and that the cost of said course is not included in the tuition.

Initials I understand that it is my responsibility to provide and file all the necessary documents to the Board of Massage Therapy in order to take the Hawaii State Licensing Exam, including a notarized massage apprentice training report.

Initials   I understand that all tuition, fees, or additional expenses must be paid in full in order to receive any documents from the Program that are required to apply for an apprenticeship permit or for the Hawaii State Licensing Exam.

Initials   I understand that the MasterBodywork Workshop and Apprenticeship program is conducted at and sponsored through The Pain Relief Center, Inc. MAE#2463.


Any and all claims, controversies or disputes arising out of or relating to this contract/agreement, or the breach thereof, which remain unresolved after direct negotiations between the parties, shall first be submitted to confidential Mediation in accordance with the Rules, Procedures, and Protocols for Mediation of Disputes of Dispute Prevention & Resolution, Inc., then in effect. If any issues, claims or disputes remain unresolved after mediation concludes, the parties agree to submit any such issues to binding arbitration before one arbitrator in accordance with the Rules, Procedures, and Protocols for Arbitration of Disputes of Dispute Prevention & Resolution, Inc., then in effect. The parties further agree that the award of the arbitrator is binding upon the parties and that judgment upon the award rendered may be entered in any court of competent jurisdiction.


I   Full Name      declare that I have read the above information provided and by signing this document agree to abide by all the requirements set forth herein.

Signature of Applicant   Date   

Signature of Principal   Date   
The Pain Relief Center Inc., by it's owner