Request edit access
Online and In Person Event Agreement Form
REQUIREMENTS AND CONDITIONS OF ATTENDANCE


In order to join any of my sessions please complete this form. The form completion is mandatory and it will then apply to any future events and sessions that you attend with me, so you will only have to do this once.

Working with therapeutic work requires various considerations  in order to guarantee an environment that is safe, respectful and contained. Prior to your attendance at any of these Working Sessions days you must complete this simple form.

Email *
Name *
Country *
I confirm that I am over 18 years old. *
Required
Have you attended a Systemic/Family Constellations Event before? *
Have you attended an 'Intention Method / IoPT' Event before? *
I confirm that I will not record any of these events that I attend. Please note that anyone found recording any event will be barred from attending any future events with Prem. *
Required
I confirm that I will not have anyone else in the room with me, nor will I share my computer with anyone else during any of these events that I attend. *
Required
I understand that being part of one of these events may involve intense emotional experiences and I accept full responsibility for my participation and any consequences it may have for me. *
Required
I confirm that I have adequate support in my life to enable me to process anything that may come up for me during one of these events, for example personal therapy, supervision, supportive friends, and so on. *
Required
I understand that should I feel the need I can follow up my experience with email contact with Prem and it is my responsibility to contact Prem for any help and support that I may need. *
Required
I confirm that I agree to confidentiality and that I will not disclose any private information about any participants in the workshops. I understand that I can share my own personal experience. *
Required
I understand that by completing this form I am making these commitments for any online and in person event that I attend with Prem. *
Required
Please advise any information that you feel I should know before working with you, in regards to prescribed medication, being diagnosed or any other medical condition that may impact your sessions. 
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report