Application Form All journeys begin with the very first step. Application Form for The Phil Parker Lightning Process® Training with Liz Allen Personal Details Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone Number * Email * Date of birth * Occupation * Thank you for choosing to apply to take the Phil Parker Lightning Process with Liz Allen. Before you are accepted onto the course, I will contact you by phone to introduce myself, to ask you some questions about your understanding of the Lightning Process and to answer any questions you may have. Through this discussion we will assess whether this training program is right for you at this time and provide you with any pre-course coaching required to help you prepare yourself for the training. Have you listened to the Part 1 of the Lightning Process audio programme or read the Introduction book? * Yes No Are you willing to attend and participate in the discussions, training and coaching sessions? * Yes No Maybe Personal History How would you describe your illness/symptoms/issues? (Include medical name/diagnosis if relevant) * When did your symptoms/issues begin? * Date of Diagnosis? * How did they start? * How has this affected your life? * Do you need wheelchair access to get to the venue? * Yes No Do you feel you can influence your own health? * Yes No Maybe Do you believe you can get better/resolve your issues? * Yes No Maybe To help me assess your suitability for the seminar please tell me if you have any medical or mental health issues that you have not yet mentioned on this form. If so, please list them: * Preparation For The Lightning Process What do you hope to achieve from doing the course? * What would you love to do with your life? * Have you applied to take the training before? * Yes No Would you like to be accompanied at the seminar? * As space can be limited on some courses, please discuss availability with me on our pre-course call. If you would like to be accompanied, this person will need to complete a separate Learning Facilitator form. Yes No Maybe Payment Details: The training fees for taking the Lightning Process training with Liz Allen is $1,650. This includes pre-training assessment and preparation as required, three half-day group seminar, 3 hours of follow-up coaching, and a graduate audio download by Phil Parker. Payment is required two weeks prior to the start of the seminar and is only payable once you have been accepted onto a course. Training Agreement: * You should only complete this application form if you agree to the terms and conditions and to the following statement: “I understand that the Lightning Process is a training programme. Its purpose is to train me in the tools of the Process, and I realise that simply attending will not guarantee me any results. I recognise the changes I want can best be obtained by fully participating and engaging in the seminars and continuing to apply it after. I am ready and committed to do this.” I have read the Terms & Conditions below and I agree with the statement above. Please use initials to represent your signature. * Date * Emergency Contact * So that we can contact someone close to you in the case of an emergency please provide the following contact details: First Name Last Name Emergency Contact Phone Number * The following must be completed if you are under 18 years of age: If you are under 18 years of age please ask your parent/guardian to read through the form and if they also agree to the Terms & Conditions, for them to tick the box below and provide their details. Agree Name of parent/guardian First Name Last Name Terms & Conditions Online Seminars By completing this form, you are agreeing that you are happy to use a third-party software package (Zoom) to participate. Confidentiality The Lightning Process is a training program and while there is no requirement for you to share personal information with other members of the group, some people may choose to do so; because of this, we require your agreement to maintain confidentiality with regard to personal information shared by others during the training. Conditions of Payment Once paid you have seven days to cancel your booking and receive a full refund if training has not commenced. After this, fees cannot be refunded in the event of a cancellation on your part, or a failure to complete the training. This is because I run small group trainings with limited spaces; if you take up a space and cancel, no one else will be able to fill it once the course starts. However, if you cancel at short notice and we are able to fill your space your fees will be refunded. I reserve the right to terminate your training if we feel your continued participation would be unhealthy or unhelpful for you or another member of the training group. Your fees will not be refunded in these circumstances. Cancellation of Seminars On occasion unforeseen circumstances may make it necessary for me to cancel a seminar and accordingly we reserve the right to cancel seminars where appropriate. In such circumstances you will be given as much notice as possible and I will either refund the full seminar fee or, if you request, move the training to an alternative date. Liability for any losses other than the seminar costs will not be accepted. Ownership In completing this form, you are agreeing to protect the copyright and Intellectual Property of the materials provided by the Lightning Process Practitioner. All documents your receive as part of your training constitute intellectual property and are not to be reproduced, lent, sold or by any other method disseminated to any other person or entity without the express written permission of Lightning Process Ltd. Such restriction applies equally to the entire contents of the materials or any part of them. You are also agreeing not the record or take photos during the seminar or any follow up. Such restrictions applies equally to the entire contents or any part of them. Copyright Notice The purpose of the Process is to apply it to resolve your personal issue/s. Participation in the Process does not amount in any way to permission to reproduce or train others in any of the techniques or materials (including graphical images, text, audio or visual presentation) that are demonstrated or provided. Data Protection Policy The Head Office for the Register of Lightning Process Practitioners is registered with the information Commissioners Office (ICO) and all information is held in accordance with the General Data Protection Regulations 2016/679 (GDPR) and Data Protection Act 1998. Please refer to the Lightning Process Head Office Privacy Policy here: https://lightningprocess.com/privacy-policy You can decide to have your attendance certificate logged, together with your name, certificate number and email address with the Lightning Process Head Office. This will: • Ensure that it can be replaced in case of loss • Help us with our research and statistics • Help us to check that you have received the high standard of care we expect from members of our register If you would like this option please check this box. In addition to the logging of your details for the purposes outlined above, we would also like to occasionally inform you of relevant developments in the Lightning Process® and its associated programmes. This is an optional service. Your details will never be passed on to anyone else for any reason. Please check this box if you wish to receive occasional and relevant correspondence from us about this. In order to conduct further research into the Lightning Process we would like to contact you at regular intervals to monitor your progress. We will not use any details by which you may be identified in any statistics that we produce. Please check the box if you agree to this. Woo hoo, you're finished! Let's get started. Thank you for filling in this form, I’ll be contacting you shortly to discuss your training with you!
