Nick’s Health and Wellness Coaching
CONSENT FORM FOR PARTICIPANT AGREEMENT

By checking “I agree to these terms” and submitting this form where indicated below, you irrevocably agree that, if Health and Wellness Coaching (we/us) approves your application and accepts you as a member of the Health and Wellness Coaching (Nutritional Coaching Program) this Health and Wellness Coaching Participant Agreement(the “Agreement”) is a binding contract between you and (Health and Wellness Coaching) and applies to your participation in The Program. By checking “I agree to these terms” and submitting this form where indicated below, you are acknowledging that you have read. Agree to and accept all of the terms and conditions contained in this agreement. We may amend this Agreement at any time by sending you a revised version at the address you provided.

By completing the Application and checking “I agree to these terms” and submitting this form where indicated below, you authorize the company to charge you a payment for your participation in the Program. You are responsible for full payment of fees for services rendered, regardless of whether you actually attend or missed session(s). To further clarify, no refunds will be issued and additional charge may apply for cancellation without a 24 hour notice. You further agree that you will be responsible for purchasing any supplements or food that you decide to use as a part of your program.

We are committed to providing all Program participants with a positive Program experience. By checking “I agree to these terms” and submitting this form where indicated below, you agree that the The Health and Wellness Coaching may, at its sole discretion, terminate this agreement and limit, suspend or terminate your participation in the program without refund or forgiveness of remaining balance if you become disruptive or difficult to work with, if you fail to follow the Program guidelines or if you impair the participation of Program instructors or other participants in the program.

We respect your privacy and personal information (collectively, “Confidential Information”) and must insist that you respect the same rights of fellow Program participants and of The Health and Wellness Coaching By checking “I agree to these terms” and submitting this form where indicated below, you agree (1) not to infringe any the Company’s copyright, patent, trademark, trade secret or other intellectual property rights, (2) That any Confidential Information shared by any representative of the Company is confidential and Proprietary and belongs solely and exclusively to the Company, (3) you agree not to disclose such information to any other person or use it in any manner other than in Program sessions and your personal healing. By checking “I agree to these terms” and submitting this form where indicated below, you further agree that (4) all materials and information provided to you by the Company are its confidential and
proprietary intellectual property belong solely and exclusively to the Company and may only be used by you as authorized by the Company, and (5) the reproduction, distribution and sale of these materials by anyone but the Company is strictly prohibited. Further, by checking “I agree to these terms” and submitting this form where indicated below, you agree that, if you violate, or display any likelihood of violating, any of your agreements contained in this paragraph, the Company will be entitled to injunctive relief to prohibit any such violations to protect against the harm of such violations.

We have made every effort to accurately represent the program and its potential Claims of actual results can be verified and examples of actual results can be provided, upon request. The testimonials and examples used are not intended to represent or guarantee that anyone will achieve the same or similar results.

This program is a combination of information found in medical literature and information acquired through clinical observation in medical clinical practice. It should not be construed as medical advice. You are advised to consult with your health practitioner in regards to any medical decision that may relate to your health. This Program is for informational purposes only. Nothing, including communications, should be taken as medical advice. You should not act upon anything without first discussing it with your health care provider. The information in this Program is designed for educational purposes only that you might better understand your condition. Any information is provided as is, with all faults, with no representations or warranties of any kind expressed or implied, including but not limited to implied warranties of merchantability or fitness for a particular purpose. You assume total responsibility and risk for using this Program and any sources related to it. No oral or written information shall take precedence over this warranty. In no event will the Company, its employees, directors or agents be liable to you or anyone else for any decision made or action taken in reliance upon the information provided through the Program.

Each individual’s success depends on many factors, including his or her background, dedication, desire and motivation. By checking “I agree to these terms” and submitting this form where indicated below, you acknowledge that as with any life endeavor, there is inherent risk. There can be no guarantee of your results due to participation in the Program. By checking “I agree to these terms” and submitting this form where indicated below, you also acknowledge that you have represented to the Company that payment of your Program membership fees will not place a significant financial burden on you or your family.