Psychic &  Intuitive Healing Skills Seminar Training Programs

Registration:

Please call Nirup at the Sedona Sacred Light Institute, 928-202-0973, with your registration questions or to take your credit card information directly over the phone or fill out this form and mail it to the address below.

Make all checks out to Sedona Sacred Light Institute.

Mail your enrollment form to: Sedona Sacred Light, PO Box 4234, Sedona AZ, 86340

Name: ______________________________________________
Mailing address: _______________________________________
City_________________ ____________State:_________Zip:__________
Home phone: (_____) _______________Day phone: (_____) ________________
E-mail:_____________________________
Date of birth:__________________ Age:__________

Check the Intuitive Healing, Psychic Development Seminar Training Program Level you will be attending:

Level 1, ______  2 Day Seminar – Pre-Registration: $500.00 _______
I am registering for full price: $550.00_______

Level 2, ______ 3 Day Seminar – Pre-Registration: $765.00________
I am registering for full price: $850.00_______

Location: A private residence in Sedona, or at one of the Sedona Resorts, the address to be given after signing up.

Credit Card Information: You can call to give information, or mail it with your enrollment form.

Name on card: ___________________________________________________________
Billing Address___________________________________________________________
Credit Card No___________________________________________________________
Expiry Date______________________________
Security Code back of card (Visa, MC, Discover – last 3 digits) ____ Front of card (Amex 4 digits) ______

Please check if you have knowledge or training in any of the following:

__ Energy Therapy __ Beginning Psychology __ Beginning Physiology __ Psychic Abilities __ Meditation __ Beginning Anatomy
__Chakra and Aura Scanning __ Massage Therapy

Please check next to your highest level of education:
__High School __ Technical School __ College

Please describe any other training you have had that is not listed: ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________

Please give a brief description of why you wish to attend this intensive and what you expect to receive from it: ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________ ___________________________________________________________________________________________________________________

SEDONA SACRED LIGHT INSTITUTE RELEASE FORM PARTICIPANT ACKNOWLEDGMENT AND ASSUMPTION OF RISKS AND RELEASE AND INDEMNITY AGREEMENT

As an enrollee, participant and student of SEDONA SACRED LIGHT INSTITUTE, from now on referred as SSLI, I understand, acknowledge and agree that I am responsible and assume all risks in engaging in all of my activity in receiving instruction, education, adventures, outings, hikes, and meditations while attending SSLI, seminars. I also assume all responsibility and risks of my person, body, decisions, physical condition, mental health, medical treatment, death, injury, illness, personal property, emotional health or disability at all times while attending SSLI seminars.

All activities I participate in may take place in United States or a foreign country and they be planned or unplanned, supervised or unsupervised and I acknowledge I am eighteen years of age or older. I agree the SSLI SEMINAR may be modified for any number of reasons including convenience, emergencies, instructor’s decision and unexpected conditions and I agree to flow with those modifications. I assume all responsibility and risks, hazards and dangers for my person and activities while attending SSLI whether inherent or not or whether described above or not. I release SSLI from, and agree not to pursue claim or sue SSLI for any liability, claim, suit or expense in any way associated with my enrollment or participation or use of any equipment, facilities, tools, toys, etc – in SSLI SEMINARS.

Neither I nor anyone acting on my behalf will make a claim against SSLI for any loss, injury, illness, personal damage, mental or emotional trauma or death suffered by me. This release includes any losses caused or alleged to be caused in whole or in part by the neglect of SSLI or its teachers, instructors, staff or volunteers to the fullest extent allowed by the law and includes claims for breach of contract or any type of suit. I do not wavier any claims for gross neglect or willful or wanton conduct. I further agree to defend and indemnify SSLI to pay or reimburse SSLI for money it is required to pay, including attorney fees and costs, with respect to any and all claims brought by or on behalf of me, act or omissions, use of equipment or facilities, including claims that SSLI and instructors, teachers, staff, volunteers for negligence. I do not agree to indemnify SSLI for clams of gross negligence or willful or wanton conduct. I agree that the substantive law of Arizona governs this document and any dispute, claim or suit I have with SSLI, regardless of the conflict rules, any mediation, suit or other proceeding must be filed or entered into only in Arizona. I agree to pay all attorney fees and costs incurred by SSLI in defending a claim or suit if the claim or suit is withdrawn to the extent a court determines that SSLI is not liable for any injury, damage or loss. This assumption of risk, release, indemnity agreement, and all other provisions in this document are intended to be interpreted and enforced to the fullest extend allowed by law. Any portion of this document deemed unlawful or unenforceable is severely and shall be stricken without any effect on the enforceability of the remaining provisions, what shall confirm in full force and effect. SSLI has full permission to use my photo, image, video, DVD, image retrieval system for sale or reproduction in any manner it desires, including advertising, display, video, DVD, training manual, etc.

SSLI reserves the right to remove any participant from the program when teacher, instructor, staff or volunteer believes with their discretion the participant or student is acting in any manner detrimental to the seminar. If participant or student is dismissed or leaves or departs for any reason, he or she will be responsible for all costs. I agree to all aforementioned above and will abide accordingly.

Signature___________________________________________________________Date___________________________
Printed

Signature____________________________________________________Date___________________________