"I understand there is a $35 refundable application fee, which will either be refunded if I am not accepted or choose not to have the session, or applied to the session fee."
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There is no obligation when filling out this application. Not everyone who applies is accepted and not everyone who is accepted chooses to have their Breakthrough. This is just a way to explore whether you are a good fit for this program and vice versa.
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Please complete this confidential application and submit it as soon as possible. It is important that we receive your fully completed application and refundable deposit before we can move forward. Incomplete applications or applications submitted without the application deposit will be deleted with no warning or notice.
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This breakthrough strategy will help you. We just need to know where you are on your journey. Just be honest about where you are now and let us help you get where you want to go!
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Please submit your completed form by hitting the "Click to Apply" button at the bottom of the form. In order to protect your privacy, DO NOT EMAIL THIS FORM.
The following is a binding agreement between you ("the client") and Mending Minds Counseling and Coaching Group upon application to participate in the Breakthrough session. By applying you indicate your consent with this agreement whether you are accepted into the program or not.
Should you be accepted and complete the consultation, payment in full is due upon making the appointment for the session.
By participating in the breakthrough session, you agree that this is provided as-is and without warrantee or guarantee however, every effort will be made by the partiture to give 100%. The success of the session depends on the extent to which the client participates. You also agree to hold harmless and indemnify Aloha J. McGregor, Mending Minds Counseling and Coaching Group, and all its employees, agents, and servants against any and all claims and actions arising out of the participation, including, without limitation, expenses, losses, judgments, fines, settlements and other amounts actually and reasonably incurred in connection with any liability, suit, action, loss, or damage arising or resulting from your participation in this program. While every precaution has been taken in the preparation and execution of this program, Aloha J. McGregor, Mending Minds Counseling and Coaching Group assumes no responsibility for errors or omissions.
CANCELLATION AGREEMENT
From the date of application to ten days before the Breakthrough session: full refund available upon cancelation. Should you need to cancel within 10-8 days of the appointment, you will be refunded the fee minus the $35 deposit. Should you need to cancel within 48 hours of the session, you will be refunded ½ the fee or be rescheduled 1 time. If the rescheduled appointment is not kept no refund available upon cancelation for any reason.
DEPOSIT DUE
A $35 USD deposit is due immediately with the client’s application to reserve evaluation of the application. No spot will be held without this deposit for any reason. If the client is not accepted or if the client cancels in accordance with the Cancelation Agreement above, the deposit will be promptly refunded.
SEVERABILITY
If any provision of these terms is declared invalid or unenforceable, such provision shall be deemed modified to the extent necessary and possible to.
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