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Dream & Shadow Courses - Enrollment & Indemnity Form
Welcome to our Online Academy, the training platform for Fran's Shala (formerly Tuning In Wellness) and Cape Cacao.

May your investment and experience in this course be used for your learning, upliftment and growth.

Please complete the form (all information is strictly confidential) and submit it at your earliest convenience.

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Email *
WELCOME! Please indicate which Course/s you are signing up for: *
PERSONAL INFORMATION
Full Name/s & Surname *
Preferred Name
Date of birth *
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Mobile number *
Email address
Residential address *
Occupation / vocation *
MEDICAL & EMERGENCY INFORMATION
Emergency Contact (name and number) *
Medical / Health Practitioner (name and number) *
What, if any, medical conditions you have? *
What, if any, medication you are currently taking? *
What, if any, plant medicines have you taken in the last six months? *
How would you describe your physical health? *
How would you describe your mental health? *
How would you describe your spiritual connection? *
Are you currently doing any forms of therapy (massage, chiropractic, physiotherapy, TRE, kinesiology, counselling, support groups, etc)? *
TRAINING ENROLLMENT
What are your goals for this training course? *
Where did you hear about this training course? *
Are you prepared to commit to this training course, using everything for your learning, upliftment & growth? *
Is there anything you feel we should know that you have not already mentioned, or that you would like to share? *
INDEMNITY AGREEMENT
I willing partake in the sessions and I will communicate if I experience any discomfort.

I take responsibility for any illness, disease, impairment and infirmity of illness that may affect my participation.

I cannot and will not hold the organisation responsible for my physical and mental health status.

I agree to abide by all verbal and written notices regarding my safety.

I have had the opportunity to ask questions about the sessions and other related issues which affect me.

The questionnaire has been completed accurately to the best of my knowledge and belief.

The organisation accepts no liability for my death, injury or illness resulting from my failure to disclose any relevant medical impairment, condition or use of product.
Do you agree with the Indemnity Agreement? *
TERMS & CONDITIONS
1) Your booking is secured with deposit. Remaining payments are to be settled according to email instructions, either via PayPal, PayFast or EFT.

2) Live sessions will be communicated to you via email. Should you not make the live session or want to redo the session a recording will be available afterwards. You will need to arrange this with the course facilitator ahead of time, via email request. The recording will then be available for one week after the session. If you would like longer that one week, then an additional R200 admin fee will be charged per week to hold the link open.

3) You will be enrolled into our Online Academy to access your course material, which will give you between 2-4 hours weekly self-study. The depth of your weekly self-study time is at your own risk.

4) Additional 1:1 sessions can be purchased as required.

5) If the session is cancelled within 24 hours, the session cannot be rescheduled or reimbursed.

6) If a session is cancelled before 24 hours and no rescheduling within the month is possible, 50% of the session will be credited for the next month, if organised within the current month.

7) There is no refund on purchased courses, sessions, product, retreats or gift sessions.

8) Sessions cannot be transferred to another person.

9) Installment payment dates are 1 month apart, and will be communicated to you when you make your deposit, or on request. An admin fee of R200 will be charged for every week that a payment is overdue.
By signing my name below, I accept and agree to the terms and provisions contained in this agreement: *
Date of submission: *
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A copy of your responses will be emailed to the address you provided.
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