Singlescoach® Date Smart Confidential Program Sign-up

Singlescoach® personal 1/2-hour coaching sessions are available in blocks of four sessions. Use this form to sign up. You will be contacted within 48 hours to schedule your first appointment. All of your information will be kept strictly confidential and will never be shared with any person or entity other than Nina Atwood and your personal coach for the program.

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First Name
Last Name
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Gender	Female Male
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What do you want to accomplish in coaching?

Block of four (4) half hour telephone sessions

$200.00


Subtotal	$200.00
Tax	0.0
Total	$200.00

SUBJECT TO THE TERMS AND CONDITIONS BELOW

Program: Singlescoach® Telephone Coaching

Fee: $50.00 per half hour; minimum block of four (4) half hour sessions = $200.00

Coaching takes place in regular half hour telephone sessions. Sessions are scheduled in advance at a regular day and time as agreed upon by coach and client.

Re-scheduling of individual coaching sessions must be done by contacting the coach directly a minimum of forty-eight hours prior to the scheduled date (unless there is an extreme personal emergency, as agreed to by coach). Client will be charged for sessions not re-scheduled with forty eight hours notice. Business issues are not an acceptable reason for re-scheduling and will result in full payment.

In order to obtain maximum results, participant agrees to follow these guidelines:

1. Be on time for sessions prepared to discuss current, relevant issues.

2. Have a notebook in which notes are taken each time.

3. Do homework assignments OR be prepared to discuss a course-correction with coach at the following session. Not doing homework is not a valid reason to re-schedule or cancel.

The SinglesCoach® Program, its content, processes, and products are the sole property of Nina Atwood Enterprises. No portion may be used or replicated without the express written consent of Nina Atwood.

Because coaching processes impact on mental and emotional areas, the program could be stressful for some individuals. By signing up for the SinglesCoach® Program, you are signifying:

1. That you are emotionally and psychologically well.

2. That you are responsible for your own well being in this process and for any results that you do or do not achieve.

By accepting these terms, you agree to hold harmless SinglesCoach®, d/b/a Nina Atwood Enterprises (NAE), its successors and assigns, from any liability resulting from business or personal decisions made as a result of coaching with NAE. You also agree to hold harmless your assigned Certified SinglesCoach, his/her successors and assigns, from any liability resulting from business or personal decisions made as a result of coaching with SinglesCoach® d/b/a NAE.

By accepting these terms, you agree that you will be charged for sessions that are not cancelled or re-scheduled with at least forty-eight (48) hours notice.

I have read and understand all of the above terms and conditions of telephone coaching through Singlescoach®. By checking this box I signify that I agree to these terms.

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