ENERGETIC BASICS : Self Registration
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FULL NAME *
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Which BASICS Immersive Dates do you want to attend? *
What attracts you to this work at this time? What do you wish to get from our class? 
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What is your experience with meditation and energy work? Please describe with detail so we can serve your needs better.  *
Please send payment before submitting this form to receive zoom link and details. Indicate your payment method below-
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How did you hear about this Immersive? *
PLEASE CHECK THE BOX BELOW TO ACCEPT AND CONFIRM THESE TERMS:

I understand that this immersive may bring up issues of a highly personal nature that may cause me to experience emotional or physical responses that may be unexpected and/or unpleasant on my part or on the part of other participants. I agree to assume this risk, including but not limited to the types of responses described.

I confirm that I do not suffer from any mental or physical impairment, and have not been diagnosed at any point with a disorder, condition, or injury, either physical or mental, that might make it inadvisable for me to assume such risks.

I agree to protecting the confidentiality of all attendees outside of our calls. 

I agree to engage with humility, openness and bring a collaborative spirit to class.

I understand that I may leave the presentation or workshop at any time for any reason.

I understand that my payment is non-refundable and non-transferrable. 

I understand our work with Come to Center is not a substitute for any form of professional, mental health or medical care. I declare that I am over 21 years of age and engage in this work freely. I understand that Come to Center, Ishita Sharma, or any supporting employee is not acting in the capacity of a medical professional, psychotherapist, physical therapist, or other licensed or registered professional, and that any advice given by Come to Center or set forth on its website should not be used as a substitute for legal, financial or medical advice or services. 

I hereby release, waive, acquit and forever discharge Come to Center, Ishita Sharma DBA Come to Center, and any and all supporting faculty, guest facilitators, their families, heirs, assistants, and employees from any claim, suit action, demand or right to compensation for damages that may arise out of acts or omissions by myself, Ishita Sharma, supporting faculty, guest facilitators, or as a result of any advice given by Come to Center and associates, information on related websites or otherwise resulting from the guidance relationship established by this agreement. 

I further declare and represent that no promise, inducement or agreement not expressed in this agreement has been made to me to sign this agreement. 

In writing my name below I hereby certify that I have read fully, understand and agree to the fee and terms set forth by this document and wish to proceed willingly.

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