Parent Name *

First Name

Last Name

Parent Phone *

Never sold.

Country

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Child's Name *

First Name

Last Name

Child's Phone *

Never sold.

Country

(###)

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I give consent for my child to participate in the Professional Coaching services offered at Life Coach Club by the provider of our choice. *

I give consent.

I understand and accept that outcomes are not guaranteed and that my child is responsible for the results of Professional Coaching services. *

I understand and accept.

I give consent for my child to be contacted by the Coach of our choice through Life Coach Club, LLC via phone, text, email, or video on the contact details listed above for the purposes of Professional Coaching. *

I give consent.

I understand that my child's participation in Professional Coaching is voluntary and can be withdrawn at any time by either party for any reason, provided in writing to info@lifecoachclub.org. *

I understand.

I understand that any personal information collected during my child's participation in Professional Coaching is strictly confidential unless Life Coach Club, LLC or it's employees determine that it is their duty to inform me or a governing body of risk or harm to themselves or others. *

I understand.

I understand and accept that Professional Coaching is not a substitution for any mental health or medical treatment and that Life Coach Club, LLC and it's employees do not engage in mental health or medical crisis or emergencies. *

I understand and accept.

I understand and agree that payment for Professional Coaching services is due at the time of service and that I can be held liable for any costs associated with Professional Coaching services completed with my child. *

I understand and agree.

I understand that I have the option to provide the payment method to the Coach of our choice to be securely stored and encrypted through the payment processing service utilized by Life Coach Club, LLC for payments to be made for my child's Professional Coaching services. *

I understand.

I understand that if I have any questions or concerns related to my child's participation in Professional Coaching with Life Coach Club, LLC or it's active employees I will contact Jessica May at 720-504-5607 or info@lifecoachclub.org. *

I understand.