Application with Waiver for Perinatal Ceremony Facilitator Training

Application with Waiver for Perinatal Ceremony Facilitator Training

www.birthspiritualityandhealing.com
Welcome!

I am honored and happy to support you in your Perinatal Ceremony Facilitator Offerings.

with love,

Gena
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What are your goals for ceremony practice? Personally and Professionally
Have you had any previous experience with perinatal and or somatic psychology, meditation and other kinds of spiritual practice? Briefly Describe:
My Products
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Perinatal Ceremony Facilitator TrainingMentor 1-1 sessions Full Fee discounted $240
$1,600.00



Perinatal Ceremony Facilitator Training- Mentor 1-1 sessions
$230.00



Perinatal Ceremony Facilitator Training -Circle Organizer
$400.00



Perinatal Ceremony Facilitator Training - Circle Member Full Fee with $200 discount
$1,400.00



Perinatal Ceremony Facilitator Training Circle Member session
$200.00 Quantity



Total

$0.00
Waiver for Perinatal Ceremony Facilitator Training

By signing this document, the participant agrees to release Gena McCarthy RN MFT#32708, from any liability, real or perceived, as a result of services received.

Ceremony and Perinatal Work can bring up strong emotions.

By signing this form the participant is stating the she feels stable and mentally and physically prepared to handle these emotions if and as they arise. Though the program is full of resourcing practices and designed to support participants to feel safe, It is also understood that the participant agrees she will seek medical, psychiatric or therapeutic help if the need arises. This help may include the services of Gena McCarthy RN, MFT#32708 and would entail a separate payment agreement than this course. By signing this form the participant agrees that Gena McCarthy MFT#32708 is not liable for any pain or emotional distress that may ensue in the course of this work.

REFUND AND CANCELLATION POLICY: NO REFUNDS. CANCELLATION NA

SPECIAL ACCOMMODATIONS: EMAIL GENAMCCARTHY3@GMAIL.COM

TO OBTAIN THE GRIEVANCE POLICY OR REPORT A GRIEVANCE PLEASE EMAILGENAMCCARTHY3@GMAIL.COM OR CALL 510-685-6827

I acknowledge that I have read this waiver, that I have executed this waiver voluntarily, and that this agreement is binding upon myself, my heirs, executors, administrators and representatives, in the event of my death or incapacity.
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