Application for Acceptance
Welcome - whatever brought you to this point in your journey, I see you and celebrate you on this HUGE Step.

I invite you to fill out this application for enrollment consideration:
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Email *
First Name: *
Last Name: *
Address: *
Phone Number: *
Date of Birth *
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Birth Time
Time
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Birth Location
Why Now? *
If accepted, what are you looking to accomplish? *
Are you committed to showing up and doing the work physically, mentally, emotionally, and energetically? *
What are the stories/wounds/pains/patterns that have caused you not to live up to your true potential thus far? *
What is this costing you if you do nothing or stay in the same cycle? *
What would your life look like if you cleared and HEALED those pains? *
Are you willing and committed to invest energy (time and money) in yourself to achieve this? *
On a scale from 1-10, how WILLING and COMMITTED are you to stretch yourself physically, mentally, emotionally, and energetically for the sake of your dreams? *
Why me as your coach/mentor/instigator? *
Have you been in any self development programs before? *
If yes, what was it and how did it impact you?
What is your profession/job/career? *
I, the signee of this application acknowledge while in this service/program, I give my permission and consent to work with Jesse Kunes and Kinterest Group LLC as well as permission and consent to deserve, allow, receive, and, believe in anything and everything meant for me in this transformational process. *
Required
I, the signee of this application acknowledge am here to inspire my own personal growth and transformation, I alone am responsible for the well-being and perception of my life. I take full responsibility for my individual experience and outcome associated with this service/program and beyond. Under no circumstances will Jesse Kunes or Kinterest Group LLC be held responsible for my actions or circumstances. Heirs, guardians, legal representatives of/and Jesse Kunes and Kinterest group LLC hereby and forever release, wave, and discharge any claims against Jesse Kunes, Kinterest Group LLC, and any of their associates affiliates or family. *
Required
I, the signee of this application understand that Jesse Kunes, Kinterest Group LLC, and Affiliates are not medical doctors and cannot diagnose, treat, or cure any disease. You should always consult with your medical doctor before making any changes to your diet, prescription medications, lifestyle, or exercise program. *
Required
I, the signee of this application agree to mutual  nondisclosure and the preservation of anonymity between I, the signee and Jesse Kunes, Kinterest Group LLC and or its affiliates for eternity regarding any and all materials, participants, and or anything and everything related to this service/program. *
Required
I, the signee of this application understand that all payments are final and nonrefundable. *
Required
I, the signee have carefully and thoroughly read and understand this agreement. I am aware that by my typed signature I am agreeing to and legally bound to the aforementioned statements and I accept these terms with gratitude for my individual Free Will choice. *
Required
Date of Submittal *
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Please Type Your Name to Confirm and Agree to the entirety of this application and agreement. *
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