Application For Enrollment & Enrollment Agreement  Logo
  • Application For Admission - No Fee

    A Emerald Valley Institute | 40 E. Broadway, Suite 213; Eugene, OR 97401 | info@emeraldvalleyinstitute.com | www.emeraldvalleyinstitute.com |(541) 525-3524. A Emerald Valley Institute prohibits discrimination against its customers, employees, and applicants for employment and student applicants on the bases of race, color, national origin, age, disability, sex, gender identity, religion, reprisal, and where applicable, political beliefs, marital status, from any public assistance program, or protected genetic information in employment or in any program or activity conducted or funded by A Emerald Valley Institute
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  • Admissions Interview Questions

    Please write a short response to the following questions:
  • Military and Veteran Information

  • Disability Status

  • Demographic Information

    To comply with federal statistical reporting requirements, A Emerald Valley Institute must ask the following demographic questions. We encourage you to provide this information, but doing so is entirely voluntary, and your application will receive the same consideration whether or not you do.
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  • We will review your application for enrollment after receiving your application.

    We affirm that our school is committed to providing equal opportunities to all individuals, irrespective of sex, age, race, color, ethnic origins, or sexual orientation. Our admissions process is conducted without discrimination, ensuring a welcoming and inclusive environment for all students.


    I certify that the information I have provided above are true to the best of my knowledge without any malice or any intention to commit acts of misrepresentation.

    I am aware that any false, misleading, or deceptive information provided may lead to withdrawal, expulsion, or any disciplinary action which may be dealt with by the school's authorities.

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  • STUDENT ENROLLMENT AGREEMENT EMERALD VALLEY INSTITUTE -This is legally binding after you are selected for admission and have chosen to move forward with the next steps and agreed to enrollment in the cohort of your choice for Emerald Valley Institute. If chosen for reduced tuition the agreement will be for the tuition agreed upon.

    STUDENT ENROLLMENT AGREEMENT A EMERALD VALLEY INSTITUTE Psilocybin Facilitator Training Program 40 E Broadway St. Suite 213 Eugene OR 97401 541-525-3524 admissions@emeraldvalleyinstitute.com
  • NOTICE TO APPLICANT:

    Do not sign this agreement before you have read it. This agreement and instrument is a legally binding contract. This agreement will go into effect if you are selected for admissions and in agreement with moving forward for registration to your chosen cohort at Emerald Valley Institute.
  • 1. Emerald Valley has the ability to offer tuition reductions for qualifying students, if you are chosen for a tuition reduction the cost of tuition will be the cost of the agreed upon tuition reduction. 

    2. You are entitled to an exact copy of this agreement and any disclosure pages you sign. This agreement and the school catalog constitute the entire agreement between the student and the school. 

    5. Although the school may provide placement assistance, the school does not guarantee job placement to graduates upon program completion or upon graduation. 

    6. While the school will make all reasonable efforts to prepare students for their OHA facilitator exam,the school does not guarantee students will pass the exam upon program completion. 7. The school reserves the right to reschedule the program start date when the number of students scheduled is too small, or for unforeseen regulatory complications and other events of “force majeure” (as defined below in Section 8) resulting in program delay 8. The school reserves the right to terminate a students’ training for unsatisfactory progress, nonpayment of tuition or failure to abide established standards of conduct. 9. The school does not guarantee the transferability of credits to a college, university, or institution. Any decision on the comparability, appropriateness, and applicability of credit and whether they should be accepted is the decision of the receiving institution. 10. The school (may/will) perform a background check for purposes of verifying that students will not be barred by OHA from receiving a facilitator license. OHA will perform background check to determine 

    fitness for certification as a facilitator. 

    11. Completion of the training program does not provide certification to practice medicine, psychotherapy, or like professions requiring board certification. The training program is specially tailored for students to receive an OHA facilitator license. 

    12. If accepted for admissions you will be enrolled in the training program for the date selected on the application. 

  • ENROLLMENT AGREEMENT 

    A Emerald Valley Institute LLC 

    40 East Broadway St suit 213 Eugene, OR 97401 

    Phone: 541-525-3524 

    Email: admissions@emeraldvalleyinstitute.com 

    https://emeraldvalleyinstitute.com 

    This Enrollment Agreement (“Agreement”) is between A Emerald Valley Institute LLC, an Oregon limited liability company (“TrainingProvider”), and the individual specified on the signature page of this Agreement (“Applicant”).

  • ENROLLMENT AGREEMENT

  • *Please note that providing your social security number is optional and will be used to verify identity and for background checking purposes. Please see our JotForm security protocol below for protecting sensitive information: 

    A Emerald Valley Institute utilizes JotForm for online application and enrollment processes. All forms are served across a protected 256 bit SSL (Secure Socket Layer) connection that uses a SHA256 Certificate. It is the industry standard protection. Submissions are encrypted with high-grade RSA 2048 at the user's computer, then transferred and stored securely on JotForm servers. JotForm is committed to upholding the five SOC 2 Trust Service Principles and received an audit report on SOC 2 compliance from an independent auditor, ensuring that they meet the latest security standards.

  • Program Information:

    Program: 
    A Emerald Valley Psilocybin Facilitators Training Program
    Program Description: 
    This program covers an OHA approved curriculum and offers a certificate of completion upon successful completion of the program. This type of certification from a certified training program is necessary to receive psilocybin facilitator certification from OHA.


    Program Length in Weeks: 10 Weeks
    Days of classes: 

    Monday, Wednesday, Friday
    Time of Classes: 

    6p - 8p (pst) *classes may go later as needed
    Enrollment Date:
    Start Date:

    Total Credit/Clock Hours: 160 Hours 

    Practicum In Person Hours: 40 Hours (included in the 160 clock hours) 

    TUITION:

    Application Fee: $0
    Enrollment Down Payment: We have multiple options available, the student can choose to pay for their program in full, or split the tuition payment into 3 equal payments upon enrollment in their program. The downpayment will be the first payment and applied to their total cost of tuition. Emerald Valley also has reduced tuition options, if a student is eligbile for the reduced tuition option the student can choose to pay in full upon enrollment or split the reduced tuition into three equal payments. The downpayment will be the first payment and applied to their total cost of tuition.

     

    Standard Program:

    Tuition Cost: $3995
    Books & Other: $0
    Other: Students traveling for in person practicum will need to cover any food, travel or lodging costs as their own expense
    Total Program Cost: $3995

     

    Accelerated Program:

    Tuition Cost: $3995
    Books & Other: $0
    Other: Students traveling for in person practicum will need to cover any food, travel or lodging costs as their own expense
    Total Program Cost: $3995

    Dual Oregon & Colorado Program:

    Tuition Cost: $4500
    Books & Other: $0
    Other: Students traveling for in person practicum will need to cover any food, travel or lodging costs as their own expense
    Total Program Cost: $4500

    Distance Education Certificate:

    Tuition Cost: $2,995
    Books & Other: $0
    Other: Students traveling for in person practicum will need to cover any food, travel or lodging costs as their own expense
    Total Program Cost: $2,995

    Emerald Valley Institute does offer reduced tuition on a case by case basis, if offered a reduced tuition amount that is the amount of tuition due for the program

     

    Emerald Valley Institute charges a $500 Non-Refundable deposit fee upon admitance and acceptance to the program.

     

  • RECITALS 

    A. Training Provider is in the business of: (i) providing an Oregon - based digital training for psilocybin service facilitators (ii) administering an Oregon -based digital education program for psilocybin service facilitators titled Psilocybin Facilitator Training Program (the “ Program”); and (iii) providing in-person practicum facilitator training per (OAR 333-333-3070). 

    AGREEMENT 

    SECTION 1 TRAINING SERVICES 

    1.1 Training Services. Subject to the terms and conditions of this Agreement, Training Provider will provide to the Applicant the training services set forth on the attached Exhibit A (the “Services”). 

    1.2 Program Dates. The Program will commence on the student enrolled “Start Date” and end 10 weeks following the Start Date (the “Term”). 

    1.3 Program Materials. Training Provider will provide access to all program materials via online video library, synchronous online learning, and email. 

    1.4 Completion Certificate. Upon Applicant’s successful completion of the Program and compliance with the rules and requirements set forth on the attached Exhibit B (the “Rules and Requirements”), Applicant will receive a certificate of completion (“Completion Certificate”); provided, however, that Training Provider may deny the issuance of a Completion Certificate if, in the Training Provider’s sole discretion: (a) Applicant did not fully comply with the Rules and Requirements, or (b) Training Provider believes Applicant cannot meet certain ethical and professional standards of conduct that renders the Training Provider unable to endorse the student as qualified to provide psilocybin services (even if Applicant fully complied with the Rules and Requirements) A lead educator or program director must endorse each student as qualified to provide psilocybin services as a condition of 

    completing the training program per OAR 333-333-3090(4). 

    1.5 Revisions to Exhibit B. Training Provider may make reasonable modifications to the Rules and Requirements at any time, in its sole discretion, however if any revisions are made that impact the student’s enrollment agreement, pertaining to their tuition payment(s) for example,

    the student must sign an official rider agreement provided by the school to indicate their approval in order for the new agreement to be considered binding.

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  • 2.2 Expenses. Training Provider is not responsible for any expenses incurred by Applicant with respect to the Program, including but not limited to any expenses for books or other necessary training materials or equipment in connection with the Services. 

    2.3 Payment By Check or Credit Card Only. Training Provider will provide for payment by Student via Check or credit card only. 

    SECTION 3 REPRESENTATIONS AND WARRANTIES OF APPLICANT 

    Applicant represents and warrants to Training Provider as follows: 

    3.1 Age and Capacity. Applicant is an individual at least 21 years of age. Applicant has the capacity, power, and authority to sign and deliver this Agreement and to perform all of Applicant’s obligations under this Agreement. This Agreement is the legal, valid, and binding obligation of Applicant, enforceable against Applicant in accordance with its terms, except as enforceability may be limited by bankruptcy, insolvency, or other similar laws of general application or by general principles of equity. 

    3.2 Accuracy of Applicant Information. All of the information that Applicant has provided to Training Provider before the signing and delivery of this Agreement, including but not limited to all of the information that Applicant provided to Training Provider in the Program Application, or Criminal Background Check Release (collectively, “Original Applicant Information”), was and is accurate in all respects, subject only to any corrections or changes that Applicant provided to Training Provider before the signing and delivery of this Agreement. 

    3.3 Acknowledgements. Applicant understands, acknowledges, and agrees that: (a) producing, manufacturing, processing, possessing, distributing, selling, and using psilocybin is a crime under the Federal Controlled Substances Act of 1970 (the “Federal CSA”); (b) the provision of facilitation or other services to an individual who buys, possesses, and uses psilocybin may, itself, be a crime under the Federal CSA, regardless of whether such services were provided before, during, or after the individual buys, possesses, or uses psilocybin; (c) Training Provider is not requiring or encouraging Applicant to violate the Federal CSA or any other applicable law; (d) although some of Training Provider’s agents or representatives may be licensed mental health professionals, none of Training Provider’s agents or 

    representatives are acting in their capacity as licensed mental health professionals in connection with the Services and will not be liable to Applicant as such; and (e) Training Provider is not responsible for providing any insurance to Applicant in connection with the Services and Applicant is solely responsible for purchasing Applicant’s own insurance. 

    SECTION 4 OBLIGATIONS OF APPLICANT 

    4.1 Rules and Regulations. Applicants will comply with the Rules and Regulations. 4.2 Applicant Information. If Training Provider requests Applicant to verify the continued accuracy of any Original Applicant Information, or if Training Provider requests Applicant to provide any new or additional information concerning Applicant (“New Applicant Information”), Applicant will promptly provide accurate responses to Training Provider. If circumstances change so that any Original Applicant Information or New Applicant Information is no longer accurate, Applicant will not later than one business day following any such change in circumstances, notify the Training Provider of such change in circumstances and describe to the Training Provider in reasonable detail the information that is no longer accurate. 4.3 Computer Equipment and Software. Applicant must have a working computer and stable internet connection that supports connection to the portals and other software platforms, including but not limited to Zoom. 4.4 Indemnification. Applicant will defend and indemnify Training Provider for, from, and against any and all claims, actions, proceedings, damages, liabilities, and expenses of every kind, whether known or unknown, including but not limited to reasonable attorney’s fees, resulting from or arising out of any breach by Applicant of any term, provision, representation, warranty, or covenant set forth in this Agreement. 

    SECTION 5 PRIVACY POLICY 

    Any and all Original Applicant Information and New Applicant Information that Applicant has provided to, or will provide to, Training Provider will be subject to Training Provider’s Privacy Policy set forth on the attached Exhibit C. 

    SECTION 6 INTELLECTUAL PROPERTY 

    1 Ownership of Intellectual Property. Applicant understands, acknowledges, and agrees that as between Training Provider and Applicant, Training Provider is the sole and exclusive owner of: (a) all of the materials and information provided to Applicant by Training Provider in connection with A Emerald Valley Institute Facilitator Training Program (the “A Emerald Valley Institute LLC 

    Materials”); and (b) all copyrights,trademark rights, and other intellectual property and proprietary rights in A Emerald Valley Institute LLC(“Training Providers Intellectual Property Rights”). Nothing in this Agreement, A Emerald Valley Institute PsilocybinFacilitator Training Program, or A Emerald Valley Institute LLC is intended to transfer to Applicant any ownership rights in or to A Emerald Valley Institute LLC Materials or Training Provider’s Intellectual Property Rights.Applicant will not acquire any interest or ownership rights in or to the Emerald Valley Institute LLC Materials or Training Provider’s IntellectualProperty Rights as a result of Applicant participating in the Emerald Valley Institute Psilocybin Facilitator TrainingProgram. Applicant may not reproduce or disseminate to any person, or in any other way publish any Emerald Valley Institute LLC Materials, whether written or oral, and regardless of the medium on which such materials exist, without the prior written consent of Training Provider, which consent Training Provider May withhold in its sole discretion. 

    6.2 License Grant. Subject to the terms and conditions of this Agreement, Training Provider grantsApplicant a limited, non-exclusive, non-transferable, non-sublicensable license to use A Emerald Valley InstitutesPsilocybin Facilitator Training Program Materials during the Term in connection with A Emerald Valley Institutes Psilocybin Facilitator Training Program and for no other purpose whatsoever. After the Term of thisAgreement, Applicant may copy, download, modify, or use A Emerald Valley Institutes Psilocybin Facilitator TrainingProgram Materials for the sole purpose of referencing the Emerald Valley Institutes LLC Materials;provided, however, that Applicant may not use the Emerald Valley Institutes LLC Materials for any other purpose,including but not limited to displaying any part of the Emerald Valley Institutes LLC Materials on any website or in any other broadcast or publications media that is distributed, made available to the public or otherwise published, or disseminating the Emerald Valley Institutes LLC Materials to third parties. 

    6.3 Termination. Except as otherwise provided in Section 6.2, upon termination of this Agreement,Applicant will immediately cease all use of the Portals andA Emerald Valley Institute LLC Materials.SECTION 7 LIMITED WARRANTY; DISCLAIMERS; LIMITATION OF LIABILITY;ASSUMPTION OF RISK 

    7.1 Limited Warranty. Training Provider warrants to Applicant that the Services will be performed by qualified personnel in a professional manner. 

    7.2 General Disclaimer of Warranties. Except for the express limited warranty in Section 7.1,Training Provider expressly disclaims all warranties with respect to the Services, express and implied,including but not limited to any warranties that may have arisen or may arise from course of performance, course of dealing, or usage of trade. 

    7.3 Specific Exclusions of Warranties Regarding the Emerald Valley Institutes Psilocybin Facilitator Training Program.Training Provider makes no warranty to Applicant: (a) that Applicant’s participation in the Emerald Valley Institutes Psilocybin Facilitator Training Program will result in Applicant successfully completing the Emerald Valley Institutes Psilocybin 8

    Facilitator Training Program; (b) that Applicant’s completion of the Emerald Valley Institutes PsilocybinFacilitator Training Program will result in Applicant learning any skills that can be utilized by Applicant ina lawful manner; (c) that Applicant’s successful completion of the Emerald Valley Institutes Psilocybin FacilitatorTraining Program will result in Applicant being qualified to be a licensed psilocybin service facilitator under the Oregon Psilocybin Services Act or pass the required OHA facilitator examination; or (d) that A Emerald Valley Institutes LLC Materials are correct and complete 

    7.4 LIMITATION OF LIABILITY. TRAINING PROVIDER’S AGGREGATE MONETARY LIABILITY TO APPLICANT UNDER THIS AGREEMENT FOR ANY REASON AND FOR ANY AND ALL CAUSES OF ACTION, WHETHER IN CONTRACT, TORT, OR OTHERWISE, WILL NOT EXCEED THE AMOUNT THAT APPLICANT HAS ACTUALLY PAID TO TRAINING PROVIDER UNDER THIS AGREEMENT. 

    NOTWITHSTANDING ANY PROVISION IN THIS AGREEMENT TO THE CONTRARY, TRAINING PROVIDER WILL NOT BE LIABLE TO APPLICANT UNDER ANY CAUSE OF ACTION, WHETHER IN CONTRACT, TORT, OR OTHERWISE, FOR ANY INDIRECT, SPECIAL, INCIDENTAL, CONSEQUENTIAL, OR PUNITIVE DAMAGES, EVEN IF TRAINING PROVIDER HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH DAMAGES. TRAINING PROVIDERS PRICE FOR THE SERVICES AND TRAINING PROVIDER’S OBLIGATIONS UNDER THIS AGREEMENT ARE CONSIDERATION FOR LIMITING TRAINING PROVIDER’S LIABILITY TO APPLICANT. 

    7.5 Assumption of Risk. Applicant understands and acknowledges that the Services involve a potentially dangerous activity, including the risk of illness, personal injury, psychological injury, pain,suffering, and disability, or death. Applicant understands that while Training Provider has implemented measures to reduce the risk of injury from the Services, Training Provider cannot 

    guarantee thatApplicant will not be injured during participation in the Services. Applicant agrees that Applicant will carefully follow instructions given by Training Provider or its agents to reduce or mitigate such risks.Notwithstanding these risks, Applicant understands and acknowledges Applicant is voluntarily participating in all activities related to the Services with knowledge of the dangers involved. Applicanthereby agrees to accept and assume all risk of illness, personal injury, psychological injury, pain,suffering, and disability therefrom, whether caused by the ordinary or gross negligence of TrainingProvider or otherwise 

    SECTION 8 FORCE MAJEURE EVENTS 

    No party will be responsible for failure to perform the party’s obligations under this Agreement due to contingencies beyond the party’s reasonable control, defined as a “Force Majeure Event,” including but not limited to the COVID-19pandemic, other pandemics, earthquakes, floods, tornadoes, and other acts of Nature, fires, wars, riots,revolutions, acts of civil or military authorities, acts of terrorism, sabotage, or nuclear incidents provided however, that nothing in this Section 8 will restrict either party’s right to terminate this Agreement under Section 9. If any obligation of a party will be delayed by a ForceMajeure Event, the party will promptly notify the other party. 

    SECTION 9 TERMINATION 

    9.1 Termination by Training Provider. Training Provider may terminate this Agreement upon written notice to Applicant if: (a) Applicant fails to make any payment required by this agreement when due, and such failure continues for 15 days after Training Provider notifies Applicant of the failure to make the payment when due; (b) Applicant breaches this Agreement (other than by failing to pay any amountsdue under this Agreement when due) and fails to cure such breach within 10 days after Training Providernotifies Applicant of the breach; (c) Applicant breaches this Agreement after Applicant has received twoor more prior notices relating to prior material breaches of this Agreement; (d) Applicant engages in dishonest, illegal conduct, gross misconduct, or abusive, defamatory, or derogatory acts or speech based on race, sex, sexual orientation, gender identity, age, religious or political beliefs,disabilities, ethnicity, or nationality in connection with the Emerald Valley Institutes Psilocybin Facilitator TrainingProgram; (e) Applicant provides any material relating to the Original Applicant Information or New Applicant Information that is found to have been untrue or becomes untrue in any material respect; (f) a Force Majeure Event occurs and delays a material obligation of either party for more than 30 days; or (g) if student violates the school’s student conduct policy 

    9.2 Termination or Withdrawal by Applicant. Applicant may terminate this Agreement upon written notice to Training Provider: (a) if Training Provider materially breaches this Agreement and fails to cure such breach within 30 days after Applicant notifies Training Provider of the breach; (b)if a Force Majeure Event occurs and delays a material obligation of either party for more than 30 days; or(c) upon notice to the Training Provider, at any time for any reason that qualifies under OAR 715-045-0036 through 715-045-0038.If Applicant terminates the Training Service Agreement under one of the qualifying reasons the provider will refund to Applicant the amount that is refundable that the applicant has actually paid to U.S.Training Provider under this Agreement refund terms are outlined as follows 

  • TIME FRAME REFUND TERMS

    If cancellation occurs within five business days of the date of enrollment, and before the commencement of classes, all monies specific to the enrollment agreement shall be refunded. *Entire amount applicant has paid will be refunded. If cancellation occurs after five business days of the date of enrollment, and before the commencement of classes *Entire amount applicant has paid will be refunded. Withdrawals that occur after commencement: Applicants will be entitled to a pro-rata refund of training program and prior to 50% on any monies collected by the training completion of the training program.Provider withdrawals that occur after commencement: No refunds provided of training program and after 50% completion of the training program

  • 9.4 Revocation of Participation and Access. Applicant acknowledges and agrees that in the event this Agreement is terminated under this Section 9, Applicant will: (a) be prohibited from further participation in the Program, (b) be removed from the Applicant’s assigned small pod group; and (c) lose access to the Portals and any other training materials or software platforms provided in connection with the Program 

    9.5 Effect Generally. The termination of this Agreement, regardless of how it occurs, will not relieve a party of obligations that have accrued before the termination. All provisions of this Agreement That would reasonably be expected to survive the termination of this Agreement will do so. 

    SECTION 10 GENERAL 

    10.1 General. This Agreement is personal to the Applicant. Applicant may not assign or delegate any of Applicant’s rights or obligations under this Agreement to any person without the prior written consent of Training Provider, which consent Training Provider may withhold in its sole discretion. This Agreement Will be binding on the parties and their respective heirs, personal representatives, successors, and permitted assigns and will insure to their benefit. This Agreement may be amended only by a written document signed by the Applicant and Training Provider. No waiver will be binding on a party unless it is in writing and signed by the party making the waiver. A party’s waiver of a breach of a provision of thisAgreement will not be a waiver of any other provision or a waiver of a subsequent breach of the same provision. If a provision of this Agreement is determined to be unenforceable in any respect, the enforceability of the provision in any other respect and of the remaining provisions of this Agreement Will not be impaired. The parties will sign other documents and take other actions reasonably necessary to further effect and evidence this Agreement. The parties do not intend to confer any right or remedy on any third party. All exhibits and other attachments referenced in this Agreement are part of thisAgreement. This Agreement may be signed by counterparts. An electronic transmission of a signature page will be considered an original signature page. At the request of a party, each other party will confirm an electronically transmitted signature page by delivering an original signature page to the requesting party 

    10.2 Governing Law. This Agreement is governed by the laws of the State of Oregon, without giving effect to any conflict-of-law principle that would result in the laws of any other jurisdiction governing thisAgreement. Subject to the terms and conditions of this Agreement, the parties will have all remedies available to them at law or in equity. All available remedies are cumulative and may be exercised singularly or concurrently 

    10.3 Arbitration. The student should first attempt to exhaust the school’s internal grievance process prior to entering into arbitration. Except as otherwise provided in this Section 10.3, any dispute,controversy, or claim arising out of the subject matter of this Agreement will be settled by arbitration before a single arbitrator in Portland, Oregon. If the parties agree on an arbitrator, the arbitration will be held before the arbitrator selected by the parties. If the parties do not agree on an arbitrator, each party will designate an arbitrator and the arbitration will be held before a third arbitrator selected by the designated arbitrators. Each arbitrator will be an attorney knowledgeable in the area of business law.The arbitration will be conducted in accordance with the procedures set forth in ORS 36.600 throughORS 36.740, with the Arbitration Service of Portland, Inc. designated as the arbitration service from which arbitrators will be selected. The resolution of any dispute, controversy, or claim as determined by the arbitrator will be binding on the parties. Judgment on the award of the arbitrator may be entered by any party in any court having jurisdiction. A party may seek from a court an order to compel arbitration, or any other interim relief or provisional remedies pending an arbitrator’s resolution of any dispute, controversy, or claim. 

    10.4 Attorney’s Fees. If any arbitration, action, suit, or proceeding is instituted to interpret, enforce,or rescind this Agreement, or otherwise in connection with the subject matter of this Agreement,including but not limited to any proceeding brought under the United States Bankruptcy Code, the prevailing party on a claim will be entitled to recover with respect to the claim, in addition to any other relief awarded, the prevailing party’s reasonable attorney's fees and other fees, costs, and expenses of every kind incurred in connection with the arbitration, action, suit, or proceeding, any appeal or petition for review, the collection of any award, or the enforcement of any order, as determined by the arbitrator or court 

    10.5 Entire Agreement. This Agreement contains the entire understanding of the parties regarding the subject matter of this Agreement and supersedes all prior and contemporaneous negotiations and agreements, whether written or oral, between the parties with respect to the subject matter of this Agreement 

  • 10.6 Non-discrimination Policy. Training Provider recognizes the contribution of Indigenous communities,BIPOC, Women, and people from the LGBTQIA+ communities in carrying plant medicine and forwarding psychedelic healing modalities. We seek to honor all those who have carried these medicines for eons despite facing persecution, cultural appropriation, extractive colonialism, and historical erasure. Wewelcome individuals from these communities and are constantly seeking ways to include these voices.We use our unearned privileges to collaborate with and support others in and from historically marginalized and oppressed communities so that they, too, may benefit from equitable access to these traditional, healing medicines and practices in a safe and welcoming space. We develop honest relationships and opportunities with diverse partners and colleagues, supporting historically marginalized communities to ensure equitable access to new modalities of treatment. With this work,we are in constant growth and reflection of our personal and collective journeys and understanding of power and 12

    privilege. We observe our steps forward, walking with respect and humility, listening more than we speak, building community and reciprocity. As such, we do not discriminate for admission on the basis of sex, age, race, color, religion, ethnic origin, or sexual orientation. We aspire to hire for adiverse psychedelic future. People from varied cultural backgrounds, beliefs, walks of life, ethnicities,races, nationalities, genders, ages, sexual orientations, abilities, and educational and professional backgrounds will together be better able to understand the complexity and nuance of the work at hand,by contributing views and practices that are often embedded in lived experiences and particular perspectives. A Emerald Valley Institute prohibits discrimination against its customers, employees, applicants and students on the basis of race, color, national origin, age, disability, sex, gender identity, religion, reprisal and where applicable political origin, beliefs, marital status, familial or parental status, sexual orientation, or all or part of an individual’s income is derived from any public assistance program, or protected genetic information in employment or in any program or activity conducted with or funded by A Emerald Valley Institute. 

  • Section 11 STUDENT CANCELLATION RIGHTS: APPLICANT IS ALLOWED TO CANCEL THEIR APPLICATION AND ENROLLMENT IN THE PROGRAM AT ANY TIME. APPLICANT IS ENTITLED TO A REFUND AS DESCRIBED IN OAR 715-045-0036 through 715-045-0038. 

    CANCELLATION AND REFUND POLICIES FOR RESIDENT EDUCATIONCancellation and Refund Policy: Resident Instruction (OAR 715-045-0036)(1) A student may cancel enrollment by giving written notice to the school. Unless the school has discontinued the program of instruction, the student is financially obligated to the school according to the following:(a) If cancellation occurs within five business days of the date of enrollment, and before the commencement of classes, all monies specific to the enrollment agreement shall be refunded;(b) If cancellation occurs after five business days of the date of enrollment, and before the commencement of classes, the school may retain only the published registration fee. Such fee shall not exceed 15 percent of the tuition cost, or $150, whichever is less;(c) If withdrawal or termination occurs after the commencement of classes and before completion of 50 percent of the contracted instruction program, the student shall be charged according to the published class schedule. The student shall be entitled to a pro rata refund of the tuition when the amount paid exceeds the charges owed to the school. In addition to the prorated tuition, the school may retain the registration fee, book and supply fees, and other legitimate charges owed by the student;(d) If withdrawal or termination occurs after completion of 50 percent or more of the program, the student shall be obligated for the tuition charged for the entire program and shall not be entitled to any refund;(e) The enrollment agreement shall be signed and dated by both the student and the authorized school official. For cancellation of the enrollment agreement referenced in Subsections (1)(a) and (b), the"date of enrollment" will be the date that the enrollment agreement is signed by both the student and the school official, whichever is later.(2) Published Class Schedule (for the purpose of calculating tuition charges) means the period of time between the commencement of classes and the student's last date of attendance as offered by the school and scheduled by the student.(3) The term "Pro rata Refund" means a refund of tuition that has been paid for a portion of the program beyond the last recorded date of attendance.(4) When a program is measured in clock hours, the portion of the program for which the student will be charged is determined by dividing the total clock hours into the number of clock hours accrued according to the published class schedule as of the last date of attendance.(5) When a program is measured in credit hours, the portion of the program for which the student will be charged is determined by dividing the total number of weeks into the number of weeks accrued according to the published class schedule as of the last date of attendance.(6) For other measurements of time such as days or weeks, the portion of the enrollment period for which the student will be charged is determined by dividing the total number of days or weeks into the number of days or weeks, accrued according to the published class schedule as of the last date of attendance.(7) The term "tuition cost" means the charges for instruction including any lab fees. "Tuition cost" does not include application fees, registration fees, or other identified program fees and costs. The school shall adopt and publish policies regarding the return of resalable books and supplies and/or the prorating of user fees, other than lab fees.(8) The school shall not charge a withdrawal fee of more that $25.(9) The school may adopt and apply refund calculations more favorable to the student than those described under this policy.(10) When a cancellation, withdrawal, termination, or completion occurs, a calculation of all allowable charges under this rule shall be made. If such calculations evidence that the school received total payments greater than its allowable charges (a) Within 40 days after notification of such cancellation, withdrawal, termination, or completion, a written statement showing allowable charges and total payments received shall be delivered to the student by the school, together with a refund equal in amount to monies paid to the school in excess of those allowable charges;(b) In the event payments to a student account are derived from federal and/or state tuition assistance program(s), including student loan programs, regulations governing refund notification and awarding within respective program(s) shall prevail in lieu of Section (10)(a) of this rule, but only with respect to the covered portions thereof; and(c) In the event payments to a student account are derived from a sponsoring public agency, private agency, or any source other than the student, the statement of charges and payments received together with an appropriate refund described under section (10)(a) of this rule may be delivered instead to such party(ies) in interest, but only with respect to the covered portions thereof.(11) In case of disabling illness or accident, death in the immediate family, or other circumstances beyond the control of the student that causes the student to leave school, the school shall arrange a prorated tuition settlement that is reasonable and fair to both parties.(12) A school shall be considered in default of the enrollment agreement when a course or program is discontinued or canceled or the school closes prior to completion of contracted services. When a school is in default, student tuition may be refunded by the school on a pro rata basis. The pro rata refund shall be allowed only if the Commission determines that the school has made provision for students enrolled at the time of default to complete a comparable program at another institution. The provision for program completion shall be at no additional cost to the student in excess of the original contract with the defaulting school. If the school does not make such provision, a refund of all tuition and fees shall be made by the school to the students.

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  • REPRESENTATIVE’S CERTIFICATION I hereby certify that the above student has read, received, and understands the cancellation policy. I further certify that there have been no verbal or written agreements or promises other than those appearing on this agreement.

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  • REPRESENTATIVE’S CERTIFICATION:I hereby certify the participant has been interviewed and in my judgment, meets all requirements for acceptance as a participant in A Emerald Valley Institutes Psilocybin Facilitator Training Program as described in the training catalog. I further certify that there have been no verbal or written agreements or promises other than those appearing on this agreement

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  • A Emerald Valley Institute LLC prohibits discrimination against its customers, employees, and applicants for employment on the bases of race, color, national origin, age, disability, sex, gender identity,religion, reprisal, and where applicable, political beliefs, marital status, familial or parental status, sexual orientation, or all or part of an individual's income is derived from any public assistance program, or protected genetic information in employment or in any program or activity conducted or funded by A Emerald Valley Institute LLC 

    14 – ENROLLMENT AGREEMENT 

    EXHIBIT A 

    Services 

    The Services include the following: 

    10 weeks of coursework and modules, including: 

    Weekly 3 evening 160-minute synchronous teaching sessions; 

    40 hour in person practicum training classes over the course of the training program;▪ Weekly and monthly asynchronous assignments, assessments, and online small group meetings as required. 

    Final assessment & completion including: 

    Final assessment in written and role play formats▪ Certificate of Completion▪ Completion ceremony 

    Forty (40) hours of practicum training and supervision 

    EXHIBIT B 

    Rules and Requirements 

    1. Rules. During the Term of this Agreement, Applicant will adhere to the following standards of conduct:

    a. Act in a manner consistent with the Training Provider’s core values of empathy, non-judgement, andrespect. 

    b. Monitor Applicant’s mental and physical health and wellbeing and take responsibility forApplicant’s self-care. 

    c. Pay careful attention to any signs in the Applicant of emotional distress, trauma symptoms,discomfort, or dysregulation and seek the help of a mental health professional if Applicant needs; 

    d. Reach out to the Training Provider’s staff if Applicant is experiencing challenges in completing A Emerald Valley Institutes Psilocybin Facilitator Training Program requirements for any reason; 

    e. Demonstrate a high level of professional etiquette and respect for professionalism during the course for instructors, speakers, and other Emerald Valley Institute Psilocybin Facilitator Training Program participants; 

    g. Create healthy spaces with appropriate boundaries in role and relationships;h. In the case of any missed learning content or in the event of any absence submit a “Leave of Absence”request to Training Provider which Training Provider may accept or reject in its sole discretion and work with Training Provider to complete an individualized education plan to ensure Applicant makes up any missed learning content, remedies any gaps in participation, and completes assignments and assessments; 

    i. Refrain from sharing or posting the Emerald Valley Institutes logo or brand identity in any way publicly and bemindful of public speech regarding the Emerald Valley Institutes Psilocybin Facilitator Training Program, and psychedelics in any form of media, including but not limited to social media or news outlets (if in doubt,Applicant may email training emeraldvalleyinstitute@gmail.com for permission); 

    j. Not attend any Emerald Valley Institute Psilocybin Facilitator Training Program sessions under the influence of any alcohol, drugs, or other awareness-altering substances. 

    k. Not market any services or products of Applicant or others to other Emerald Valley Institutes Psilocybin FacilitatorTraining Program participants 

    l. Keep the identity and personal information of any other Emerald Valley Institutes Psilocybin Facilitator TrainingProgram participants, staff members, agents, faculty, or volunteers of Training Provider confidential by refraining from using any names or other identifying information or taking any photos, videos, or audio recordings of such individuals. 

    2. Requirements. During the Term of this Agreement, Applicant must: a. Actively participate in small group integration sessions, workshops, assignments, assessments,and other coursework; 

    b. Attend a minimum of 100% of the Emerald Valley Institutes Psilocybin Facilitator Training Program (subject to aLeave of Absence request accepted by Training Provider as provided in Paragraph 1.f above); 

    c. Receive a “pass” grade on all required assignments and assessments; d. Complete the Training Program no later than two (2) years from the Start Date of their initial cohort;3. Disciplinary and Appeals Process. If Applicant fails to comply with any provision of Paragraphs 1 or 2 above or exhibits behaviors causing concern for Applicant’s ability to participate in or complete the Emerald Valley Institutes Psilocybin Facilitator Training Program:a. A notice will be sent via email to Applicant (the “Notice Email”), requesting a Zoom meeting or a written response from Applicant to the concerns expressed by the Training Provider in the Notice Email;b. Applicants must respond to the Notice Email as soon as possible, but no later than 14 days after the date of the Notice Email;c. If Applicant fails to respond to the Notice Email within 14 days after the date of the Notice Email,Training Provider may immediately expel Applicant from the Training Program.d. If Training Provider desires to have a Zoom meeting and Applicant responds to the Notice Email Within 14 days after the date of the Notice Email, the Applicant, the Director of Education, and theProgramDirector will attend a Zoom meeting to discuss the concerns expressed in the Notice Email (the“Disciplinary Meeting”);e. Following the Disciplinary Meeting, Training Provider will determine a course of action pursuant to which, in Training Provider’s sole discretion, the Applicant may be: (i) immediately expelled from theTraining program or (ii) offered a probationary period subject to specific conditions determined inTraining Provider’s sole discretion (the “Conditions”), which Conditions may include the creation of an individual education plan, and during which period Applicant may be immediately expelled from the Emerald Valley Institutes Psilocybin Facilitator Training Program if Applicant breaches any such Conditions;f. If Applicant is immediately expelled from the Training Program, Applicant may appeal the expulsion by emailing Director of Education at emeraldvalleyinstitute@gmail.com with the subject line “DisciplinaryAction Appeal” and explaining the reasons for which Applicant should not be expelled from the Emerald Valley Institutes Psilocybin Facilitator Training Program (the “Appeal Email”);g. Decisions of disciplinary decisions described in subsections e and f above will be made in writing,retained as part of the Applicant’s student file for a minimum of 3 years, and shall be made available to an Applicant, and h. Training Provider will determine the merits of the appeal and Applicant will be notified ofTraining Provider’s final decision within 10 business days of the date of the Appeal Email 

    EXHIBIT C 

    Privacy Policy Subject to any U.S. privacy laws or any other local privacy laws in Applicant’s jurisdiction,Training Provider will take reasonable steps to maintain the confidentiality of any personal information that Applicant has provided to Training Provider, including but not limited to the Original Applicant Information or New Applicant Information (“Applicant’s Personal Information”). Notwithstanding the foregoing, there is an inherent risk that electronic communications between Applicant and TrainingProvider may be unlawfully intercepted by third parties not under Training Provider’s control. TrainingProvider does not guarantee the security of any information transmitted via the Internet, telephone, text message. Applicant may authorize Training Provider to disclose any of Applicant’s information to a third party in writing signed by the Applicant.Applicant’s Personal Information will not be used by Training Provider for any purpose other than for providing Applicant with the Services specified herein without Applicant’s express written consent.Notwithstanding the foregoing, Training Provider may disclose Applicant’s Personal Information when necessary to protect the safety of Applicant or another person or as otherwise required by law, court order, or legal process, including in a response to any governmental or regulatory request. Personal Transcripts of the Applicant will be made available to the Applicant in compliance with the “FamilyEducational Rights and Privacy Act” (Public Law 93-380 as amended by Public Law 93-568).Applicant’s personally identifiable information will not be made available to anyone other than the student, Higher Education Coordinating Commission, or other local, state, or federal officials as allowed by law. Applicant’s personally identifiable information will be delivered on electronic format to theHigher Education Coordinating Commission at least once a year. Personally identifiable information of Applicant will be maintained in accordance all applicable laws, including but not limited to the OregonConsumer Identity Theft Prevention Act, ORS 646A.600 to 646A.628, and any rules adopted pursuant toORS 646A.600 to 646A.628.Training Provider will not use Applicant’s image or voice for any reason without the written consent ofApplicant; provided, however, that Applicant understands and agrees that Applicant’s image or voice from a recorded training session may be used in training materials used by Training Provider inconnection with the Program without Applicant’s written consent. 

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  • Signature of Training Provider Official Date REPRESENTATIVE’S CERTIFICATION:I hereby certify that the participant name has been interviewed and in my judgment, meets all requirements for acceptance as a participant in A Emerald Valley Institutes Psilocybin Facilitator Training Program as described in the training catalog. I further certify that there have been no verbal or written agreements or promises other than those appearing on this agreement

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