"Agreements for Registration"
This program is intended as a personal
growth experience and should not be looked upon as a
substitute for psychotherapy. It can involve dramatic
experiences accompanied by strong emotional and physical
release. This program is not appropriate for pregnant
women or for persons with cardiovascular problems, sever
hypertension, sever mental illness, recent surgery or
fractures, acute infections, illness or epilepsy (see
If you have any doubt whether or not you should
participate, consult your physician and/or therapist, as
well as the facilitator, well before
1. I agree that my presence in this
program indicates that I have considered the nature of
the program and have chosen to participate on my own
responsibility and at my own risk. I know of no recurring
conditions, physical, emotional or mental, which suggest
to me that I will be unable to successfully fully engage
in this program.
2. I understand that this program may
bring up unresolved issues or conflicts, either current
or from the past, and I agree to be responsible for
maintaining my well being while I work to resolve these
3. I understand that this program is
not therapeutic in design, intent or methodology, and
that the facilitator(s) and any assistants may not be
trained mental health professionals.
4. If I have complaints or problems
with the delivery of the program or with any other aspect
of my participation in this program, I agree to
communicate those complaints directly to the facilitator
and to work with them to resolve any
5. I understand that, while I am free
to share my experience of the program, the concepts,
processes and material presented during the program are
most effective when presented within the context of the
program. I therefore agree not to communicate the content
or processes of the program to any non-participant nor to
present or use the material as my own.
6. I agree to hold all individual's
experiences during the program as confidential and to
create a safe environment in which my fellow participants
may experience their own process.
7. I agree to let the leader lead. I
further agree not to process other people or answer their
shares or give them advice.
8. I understand that my uninterrupted
participation is necessary for the successful delivery of
the program and that the value I receive from the program
will be largely a function of my commitment and
participation. I therefore agree to arrive on time,
return from breaks on time and remain through the entire
I agree to never
become sexual with any participant from my workshop
unless I have previously developed such a relationship
with that person. This allows an extra level of safety
for those who might have been sexually abused growing up
and for all participants to explore non-sexual intimacy.
10. I declare that I am personally
responsible for the results I create from my voluntary
participation in this program.
Signed ________________________________ Print