Reconsolidation of Traumatic Memories RTM Registration Form - June 2024 Logo
  • Reconsolidation of Traumatic Memories Training Registration Form

    Please fill in all required fields below
  • The next 3-Day training will be held at The Evolution Group, Inc. on the following days:

    • June 26th, 2024 - 8:30AM - 6:00PM
    • June 27th, 2024 - 8:30AM - 6:00PM
    • June 28th, 2024 - 8:30AM - 6:00PM

    Lead Trainer: Daniel Blackwood, LPCC

    Coaches: Crystal Ellison, LCSW & Kaitlyn Richter, LCSW, Josie Zabala, LMHC

     

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  • AGREEMENT

    & Acknowledgement
  • Release Agreement between PTTI LLC, The Research and Recognition Project, Inc. and Reconsolidation of Traumatic Memories Protocol™ training participants, referred to as “Trainee” below, regarding Training in the Reconsolidation of Traumatic Memories Protocol™ for Licensed Health Care Professionals and Unlicensed Mental Health Practitioners supervised by Licensed Mental Health Professionals.

    This Traumatic Memories Protocol™™ Training Agreement for Licensed Mental Health Practitioners (“Agreement”) and Unlicensed Health Care Practitioners professionally supervised by Licensed Mental Health Professionals, is entered into effective the date of signature by and between PTTI LLC and The Research and Recognition Project, a 501(c)(3) Charitable Organization (“R&R”) and the undersigned (“trainee” or “I” in all agreements below)

    1. I understand and agree that I am receiving intensive training on the Reconsolidation of Traumatic Memories Protocol™ from PTTI LLC so that if certified by the Research and Recognition Project I can utilize the Reconsolidation of Traumatic Memories Protocol™ and related material to help the clients I work with eliminate or lessen the symptoms associated with Traumatic Memories. I will take responsibility to understand, all state, local, federal and international laws, rules and regulations and to abide by those laws, including obtaining any other necessary certifications or licenses needed to administer the Reconsolidation of Traumatic Memories Protocol™ legally where I practice.

    2. I accept that any written or clinical alteration of the manualized Reconsolidation of Traumatic Memories Protocol™ process nullifies my certification to administer the Reconsolidation of Traumatic Memories Protocol™.

    3. I accept that I am not certified to administer the Reconsolidation of Traumatic Memories Protocol™ until I have successfully completed both the training and testing process for certification.

    4. I further recognize that additional training and written certification and authorization as an RTM Trainer is required to train others in the Reconsolidation of Traumatic Memories Protocol™, and that the training I am now receiving does not qualify me to train others in the Reconsolidation of Traumatic Memories Protocol™.

    5. I agree not to offer trainings or train others in the Reconsolidation of Traumatic Memories Protocol™, or in any way claim that I am teaching/administering the same process that has been and is being researched by the R & R Project, without additional specialized training, testing, and certification as an “Reconsolidation of Traumatic Memories Protocol™ Trainer" provided through the R&R Project.

    6. I agree not to state that I have been certified as an administrator of The Reconsolidation of Traumatic Memories Protocol™ in any research project, or to conduct research in The Reconsolidation of Traumatic Memories Protocol™, unless I have explicit written permission from The Research and Recognition Project Inc.

    7. I understand that the Reconsolidation of Traumatic Memories Protocol™ script and any other Reconsolidation of Traumatic Memories Protocol™ training material provided by PTTI LLC and the Research and Recognition Project is proprietary copyrighted material. I may only reproduce it for my use as a clinician for one-on-one work with clients and otherwise I will not share or distribute to others. During the course of the training, I will be receiving confidential and proprietary information such as written material, methods of administering the Reconsolidation of Traumatic Memories Protocol™, and other forms of intellectual property exclusively owned by R&R . I agree to not use any such material for any purpose other than during my training and as a clinician for one-on-one work with clients and will not distribute the materials to others.

    8. I will not use the Training Materials or any other confidential or intellectual property owned by R&R to train, or allow others to train the administering of the Reconsolidation of Traumatic Memories Protocol™. I will not use the materials to compete with the training of the Reconsolidation of Traumatic Memories Protocol™.

    9. For breaches of this agreement, I agree that the liquidated damages value of each person trained in the Reconsolidation of Traumatic Memories Protocol™ is $5000.

    10. In the event of a breach of this agreement the breaching party shall be obligated to and agrees to, defend, indemnify and hold harmless, and pay for the reasonable attorney fees, costs, and expenses relating to the enforcement of the rights of the other party pursuant to this agreement.

    11. Parties agree that the Trainee is neither an employee or independent contractor of PTTI LLC or R&R Project

    12. If the R & R Project certifies me in the administration of the Reconsolidation of Traumatic Memories Protocol™, I will hold harmless the R & R Project and PTTI LLC for any situation, legal or otherwise, resulting from my administration of the Reconsolidation of Traumatic Memories Protocol™ whether or not, I administered the Protocol™ as taught by PTTI LLC and the R & R Project.

    13. If any provision or provisions of this Agreement shall be held invalid, illegal, unenforceable or in conflict with the laws of any jurisdiction, the validity, legality and enforceability of the remaining provisions shall not be affected of impaired thereby.

    14. This Agreement contains the entire understanding between parties pertaining to the subject matter of this Agreement and supersedes all other prior written or oral agreements between the Parties regarding the subject matter.

    NOTICE OF FILMING AND PHOTOGRAPHY when you enter a PTTI LLC or R&RProject, event, or program, you enter an area where photography, audio, and video recording may occur. By entering the event premises, you consent to interviews, photography, audio recording, video recording and its/their release, publication, exhibition, or reproduction to be used for news, web casts, promotional purposes, telecasts, advertising, inclusion on websites, social media, or any other purpose by PTTI LLC and Research and Recognition Project and its representatives.

    Images, photos and/or videos may be used to promote similar PTTI LLC and Research and Recognition Project events in the future, highlight the event and exhibit the capabilities of Research and Recognition Project. You release PTTI LLC and Research and Recognition Project, its officers and employees, and each and all persons involved from any liability connected with the taking, recording, digitizing, or publication and use of interviews, photographs, computer images video and/or or sound recordings.

    By signing below you acknowledge your understanding and have given consent to PTTI LLC and the Research and Recognition Project for release.

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  • Intake Form

  • Thank you for choosing to attend The Research Recognition Project’s Reconsolidation of Traumatic Memories training, 01/17/2023 - 01/19/2024, for licensed mental health counselors/therapists. The program will begin promptly at 9:00AM - 6:00PM.

    The initial, training will be followed by individual, phone coaching sessions, The coaching sessions are aimed at helping Trainees recruit and administer the RTM protocol to clients with traumatic memories. All participants will receive training manuals and
    clinical materials necessary for RTM Protocol administration.

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  • *All information given will be used solely for internal distribution Between employees, representatives and other therapists associated with Research and Recognition Project*

  • NOTICE OF FILMING AND PHOTOGRAPHY

  • When you enter a Research Recognition Project Training, event, or
    program, you enter an area where photography, audio, and video recording may occur.

    By entering the event premises, you consent to interviews, photography, audio recording, video recording and its/their release, publication, exhibition, Or reproduction to be used for news, web casts, promotional purposes. telecasts, advertising, Inclusion On websites, social media, or any Other purpose by Research end Recognition Project and its representatives.
    Images, photos and/or videos may be used to promote Similar Research and Recognition Project events in the future, highlight the event and exhibit the capabilities of Research and Recognition Project. You release Research and Recognition Project, its officers and employees, and each and all persons involved from any liability connected with the taking, recording, digitizing, or publication and use of interviews, photographs, computer images video and/or or sound recordings.

    By signing below you acknowledge your understanding and have given consent to the Research and Recognition Project for release.

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  • Payment Information

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        Note:

        Payment must be made in advance for this registration. A member from The Evolution Group, Inc. Learning & Professional Development will reach out for payment prior to the training. Click the “Complete Registration” button to reserve your spot and genrate an invoice for the training. Depending on which options this organization has configured, you may be able to pay with a credit card online or print an invoice and pay with a check. Please note that your registration will not be confirmed until payment is received.

        If you are regsitering with a scholarship, please obtain the Coupon Code from the sponsor of your training.

      • REFUND POLICY

        All payments are final. We do not provide refunds for membership signups and renewals, event registrations, donations, storefront purchases, or other misc. charges. Please carefully review the charge(s) checked above and be sure you know what you are paying for.


        The refund policy is set by The RTM Protocol. If refunds are available, requests must be directed to The RTM Protocol - they cannot be handled by ClubExpress.

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        Note:

        If you will be traveling from out of town and require accommodations, we have provided links below for your convenience to book a room at one of the hotels with discounted rates

        Hilton Garden Inn Downtown - Special Rates/Corporate Account Code: 3249238

        Homewood Suites by Hilton - Special Rates/Corporate Account Code: 2640533 

        If you have any questions or concerns, don't hesitate to reach out to the Training Coordinator, Kalika Valerio (kalika@theevolutiongroup.com or 505-242-6988 ext. 120) 

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