Courage + Motivation Coaching Program

Thank you for your interest in joining C+M Coaching Program. We look forward to assisting with your personal and/or business/career growth.

Congratulations you are one step closer to unlocking your GREATNESS!

Coaching Packages & Memberships: (All sessions are 1 hour)

Standard Package = Personal Growth & Development (3 Sessions)
Standard Package Membership = Personal Growth & Development (1 Monthly Session)
Plus Package = Personal/Career/Business Growth & Development (6 Sessions)
Plus Membership = Personal/Career/Business Growth & Development (2 Monthly Sessions)
Youth Package (Group) = Personal Growth/Self-Improvement/Social Emotional Learning (10 Sessions)
Youth Membership (Group) = Personal Growth/Self-Improvement/Social Emotional Learning (Monthly Sessions)
CM Choice Package = Personal/Career/Business Growth & Development (6 Sessions) - All CM Choice Package Sessions are 30 minutes each.

Please complete the NEW MEMBER enrollment form below

Name (member)

First Name

Last Name

Parent/Guardian Name (if applicable)

First Name

Last Name

Name on Facebook (adults only)

Type name exactly as it appears on Facebook (for private group)

Date of Birth (member)

MM

DD

YYYY

Age (member)

Email Address

Phone

(###)

###

####

T-Shirt Size

Personality Type Score (ex. E-S-T-J)

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

What Are Your Presenting Challenges (what will you like to improve/develop)?

What Are Your Desired Outcomes (what are you looking to gain)?

Referred to C+M Coaching by who?

Coaching Package & Membership

Choose Package and Membership that apply. Membership fees will not be charged until sessions from initial Package plan is complete.

Standard Package (personal)- $499

Standard Package Membership (monthly) - $149

Plus Package (personal & business) - $999

Plus Membership (monthly) - $249

Youth Package (Unlock Your Greatness) - $499

Youth Membership (Unlock Your Greatness) - $49

CM Choice Package

Debit/Credit Card Number

Not Required For CM Choice Package

Expiration Date (Month/Year)

CVV

Name on Card

Billing Address

If the same as above type "same." If different from above, please complete.

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

All members will be enrolled in recurring month to month memberships based on the membership package selected. Standard Packages selected is a one time transaction. Any cancellations require 30 day emailed request.

Any additional services can be added at any moment after initial enrollment using your provided information. All personal information is secured and protected.

Terms of Service:

Consent to Participate in the C+M Coaching Program: I, as the Parent or Legal Guardian of the child named above who is to participate in program, give my consent for their participation. I am aware that there are potential hazards and risks involved in some programs and am willingly allowing the child mentioned above to participate in all aspects. I agree to hold harmless and indemnify the C+M Coaching Program, and/or its employees, agents, or lessors from any and all claims by myself, my child, my heirs, my family, or my assigns.

Consent to Use Photographs: I give my consent to the C+M Coaching Program to use videos and/or photographs of my child for brochures, to display in photo albums, in advertisements, or for other publicity purposes. If my child’s photo is used, he/she will only be identified by first name.

C+M Coaching services are provided to both Youth and Adults. Consent to participate and to use photographs apply to both youth and adult members.