EFFT Essentials Registration Form

EFFT Essentials

May 19-21, 2026 | Hurricane, WV
Attendee Information

Please complete for each attendee to receive the group rate.
Preferred Name on Badge*

First NameLast Name
Name on Certificate of Completion*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
License Type, State & Number*
What is your profession or license type, license state and license number?
Accommodations Requested
Are there any accommodations you would need to help you be comfortable during the training?
Food & Allergies
It is common for us to provide light snacks. Do you have any life-threatening food allergies we should know about so that we do not provide those types of foods/snacks.
Confidentiality Statement

An important part of learning in EFT is seeing it unfold in action by watching live unscripted psychotherapy and consultation sessions. All personal content of the large group and small group, and all clinical material shown during this training is confidential. As a participant, you agree to keep confidentiality.
Confidentiality Statement*

I agree to the Confidentiality Statement.
Refund Policy

Refund Policy: 80% refund up to one month prior to training. No refund after one month prior to training unless the spot can be filled.
Refund Policy*

I agree to the Refund Policy.
Subject Privacy

To protect the privacy of the individuals who have generously agreed to have their therapy process shown for training purposes, I agree that if I recognize any person in the clinical cases shown, I will let the facilitators know so that they can provide an alternative training video for me to learn from.
Subject Policy*

I agree to the Subject Privacy Statement.
No Recording Agreement

I agree to not record any part of this training in any format (audio, video, or visual). Personal handwritten or typed notes of non-confidential material are permitted.
No Recording Agreement*

I agree to the No Recording Agreement.

My Products

**Early Bird - Individual Rate Product Image

**Early Bird - Individual RateEarly Bird Rate - good through January 31, 2026. On Feb 1, 2026 price will change to $845.00.

$450.00

Student RateAvailable to current graduate students in counseling, social work, psychology, or related programs. Valid student ID or enrollment verification required.

$400.00

**Early Bird - Group RateIf 5 or more individuals from the same organization/group are registering for the training there is a $50 discount on the rate. This rate is valid through January 31, 2026. On Feb 1, 2026, the price will change to $795 / person. Each person must register for the training separately.

$400.00

Total

$0.00

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EFFT Essentials

Attendee Information