BREAKING OPEN, BREAKING THROUGH Fall/Winter 2024 Onboarding Form

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A Transformational Journey for Women to Reclaim Their Power With Liberation Coach Sarah Shourd

We're thrilled that you're ready to commit to this groundbreaking 12-week transformational group coaching container, LIVE and ONLINE sometime in the Fall of 2024 (details to come). View the full program schedule and details here.

Somatic coaching is collaborative and client-centered, so please let me know if you have any questions, tensions, or concerns. I always want to hear what’s in your heart, in general and in our connection. Please don't hesitate to reach out to me for support or clarification if you're struggling or unsure about anything. 

Submit this form to hold your spot. After submitting your information below, you will receive a separate invoice in your email address from "Shourd Somatics" within 24-48 hours; your spot is fully confirmed after you've submitted payment (payment plan info below). There will also be an optional In-Person Integration Gathering for participating[ants living in the Bay Area, date TBD.

If you still have any questions about participating you can email me at shourdsomatics@gmail.com or schedule a discovery call at shourdsomatics.com or call me at (702) 415-3345.

I look forward to reading your responses, and seeing you soon!

Your email

First and last name

Preferred Pronouns

Phone Number for WhatsApp Communication (optional)

How did you hear about this program?

What draws you to this course?

How would you describe your current emotional state? How is your healing journey going so far?

What has been the best kind of support for you? What has worked?

What are the biggest challenges you're currently facing that you hope this container will support you with? The more specific you can be, the better we can try to tailor the content of this program to be supportive of your needs.

Are you currently investing in other healing or support system(s)?

What would success look like for you after completing this 12 week journey?

Please read all of the group agreements and acknowledge your commitment to adhere to them throughout our time together.

I agree

I have questions before I can agree

Clear selection

TIME AND DATES: The dates for this course are not set yet. TIME will be announced based on the preference of participants.

If you have a time preference, please check all of the boxes that work for you.

10am-noon PST

11am-1pm PST

2pm-4pm PST

Please confirm the price point you're able to participate in this program. Multiple price points are given to make this experience as accessible as possible. Please read the descriptions below and choose the highest price point you can comfortably afford to help us offer more supported access to those with fewer resources. This confidential information will not be disclosed to other participants in the program.

1,585 (Re-Balancing Level - “I have more than enough resources and would like to contribute to re-balancing inequity.”)

1,285 (Standard Level - “I have sufficient resources and can participate at the standard level.”)

999 (Supported Level - "I am under resourced and would benefit from community support.”)

Scholarship Level - I am requesting additional community support & understand these are offered on a case-by-case basis. Selecting this option does not guarantee participation in this program.*

Clear selection

Would you like to pay in full or via the payment plan (invoiced every 3 weeks).

Re-Balancing - $1585 or 3 payments of $528

Standard - $1285 or 3 payments of $428

Supported - $999 or 3 payments of $333

One Time Payment

Payment Plan

Clear selection

Are you interested in adding on additional support through a discounted 1:1 private coaching package that's only available to Breaking Open, Breaking Through group participants?

1) Lite: $300. Three 1-hour private coaching sessions of personalized advice, suggestions & support, scheduled at your convenience. The full price is $600.

2) Robust: $600: Six 1-hour private coaching sessions every other week for the duration of the 12 week program, with an extra one pre or post course. The full price is $1,200.

Yes, please invoice me for Lite 1:1 Coaching Support

Yes, please invoice me for Robust 1:1 Coaching Support

No personalized support upgrades; just the group coaching support.

Thanks for offering a discount to make this more accessible but I can pay the full price.

Clear selection

Video & Audio Release Form Statement

This course will be recorded via zoom. Breakout rooms will not be recorded and your likeness will never appear in social media or other marketing channels without your permission. By agreeing below, you understand that your likeness may be captured in video footage during the online course sessions. The video recordings containing your likeness may be used for future online course purposes, but your permission will be asked first.

I agree with all the above

Other:

Clear selection

Do you have any questions and concerns about participating in a program like this? Anything else you'd like to share?

Do you have any accessibility needs in regards to participating fully in this program?

Today's Date*

YYYY

Please type your name a a signature to verify your above responses.

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