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Application Form for The Phil Parker Lightning Process® Training

With Berit Frivold


Name:        ________________________________   Male/Female:  _______________________

Address:     ____________________________________________     

                   ____________________________________________   City: ____________________  State: ____   Zip:____________

Tel home:   _____________________        Cell / work phone:  _________________________________

Email address:  ____________________________

Date of Birth:     _________________

Occupation/Previous Occupation: _________________________________________________



Thank you for choosing to apply to take the Phil Parker Lighting Process® with Berit Frivold.  Please take the time to go through this form as it will help me to find out more about you and what you are hooping to achieve from taking this training.  If you have any questions, please contact me at Info@BeritFrivold.com.  Tell me how best to contact you by phone and I’ll be happy to call you and try to answer you questions and address your concerns.


Preparing for your training


The Lightning Process™ is a training program, not a treatment or a therapy, so you need to be ready to learn. Our experience is that if people apply these skills/tools that they learn from doing this course, then they are able to make changes to achieve new levels of health, wellbeing and happiness.


The Lightning Process™ is all about you and your future.As it is you future, you have the biggest role to play during the seminar, will have to do the most work and be very determined.  This is why we recommend that you have more of a commitment to the training and success than just ‘wanting to give it a go’.  Having said that, you will not be alone on your journey, I your practitioner will be there for you before, during and after the course to help you to keep putting the Lighting Process into practice.


We have found that the very best way to help you to prepare yourself to get the most from the training is to read/listen to the book/audio book ‘An introduction to the Lighting process which is available fro the office or website:  www.lightingprocess.com.  Also take some time to read through the website, especially the feedback and stories from people who have already done the Lightning Process.  If you know anyone who has done a Lightning Process course, as them about their personal experience of the Process and contact me if you have any specific questions you would like to discuss.


1. Have you read the book/listened to the audiobook/had the book read to you?     
Yes  
No


If you feel that you are ready to take the course, then please complete the form.  Before you are accepted into the course I will contact you be 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 discussion with you, 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.


About the Lightning Process Course

The Lightning Process is an empowering training program which teaches you how you can influence your health and life using techniques based on the way the brain works and body interact.  It involves specific steps using movement, posture and coaching which can be tailored to the abilities of the individual, if needed. 


The course usually takes place in small groups, over 3 consecutive days. Sometimes the course is offered as a 1-1 program. Each seminar is approximately 4-5 hours, including breaks.


On completion of the course you will receive an attendance certificate.


Expectations:

What you can expect from me, your trainer:

  -  I will work with you with care and integrity.

  -  I will follow the approved ethical training structure

  -  I am completely committed to you and your success.


In return, what I expect of you:

  -  That you are ready and committed to fully participate and engage in te training and be ready for interesting and fascinating approaches to change.


  1. 2.Are you willing to attend and participate in the discussions, training and coaching sessions? 
    Yes  
    No  
    Maybe


  1. 3.Personal History:

   

    How do you describe you illness/symptoms/issues (include medical name/diagnosis if relevant)

   

    Diagnosing physician/health care provider:  _______________________

   

    Date of Diagnosis:  __________________


    When did the symptoms/issues begin?  _____________


    How did they start?   _______________________________________________________________________________________

   

    How has this affected you life?   ______________________________________________________________________________

                     

                                                        ______________________________________________________________________________

                   

                                                        ______________________________________________________________________________


  1. 4.Do you feel you can influence you own health?  
    Yes  
    No  
    Maybe


  1. 5.Do you believe you can better/resolve you issues? 
    Yes  
    No  
    Maybe


It is important for me to know about you general state of health and health history both physically and mentally.  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:   






The reason I ask about your past medical history is not because I have medical training, but I do need to know if you need help in addition to myself, your Lightning Process Practitioner.


Do you need wheelchair access to the to the venue? 
Yes  
No


  1. 6.Your Lightning Process Course

What do you hope to achieve from doing the course?


When you have discovered a way to get well and resolve your issues, what would you love to do with your life?


    1.


    2.


    3.


    4.


    5.


    6.

   


  1. 7.Do you know of someone or have you spoken to someone who has used the Lighting Process to recover their health?

    
Yes  
No


  1. 8.Have you applied to take the training before?
    Yes  
    No  (If ‘No ‘ to to question 9)

   

If  ‘Yes’ which practitioner did you apply to?    ________________________


And when?  __________________


What has changed for you since applying to that practitioner?   _______________________________________________________


                                                                                                    _______________________________________________________


I may need to speak to that practitioner about your application, please confirm that you give me permission to do this.
Yes  
No


  1. 9.I would life to be accompanied at the seminar 
    Yes  
    No  
    Maybe

As this is a personal journey, most people decide not to have someone with them when they attend the Lightning Process course.  However, it is a decision for you to make as to whether you wish to bring a family member or friend with you.  If you chose this, we have that the kinds of qualities ideal for someone who attends to support you in your learning are to be fully supportive, positive and inspiring.


As space can be limited on some courses, please discuss availability with your practitioner during you phone call, if you would like to be accompanied.  This person will need to complete a separate Learning Facilitator form.


10. Confidentiality

The Lightning Process is a training program, not therapy, and there is no requirement for you to share personal information with other members of the group, but some people may choose to do so.  Do you agree to maintain confidentiality with regard to personal information shared by others during the training?
Yes  
No


  1. 11.Payment Details

The fees for taking the Lighting Process™ with Berit Frivold is a total of $1.500


This fee includes:


    a.  Pre-training Screening and coaching.

         - determining if this is right for you - preparing you for the program -

    b.  Three days of intensive training and study materials

    c.  A follow-up CD by Phil Parker - for review and inspiration

    d.  5 follow-up coaching sessions by telephone, Skype or e-mail 

        - the schedule for follow-up is intended to answer questions and give guidance  and motivation following the training        

          program


The follow-up schedule is approximately:

        - after 1 wk, 1 month, 3 months, 6 months and 1 year


The payment can be made by personal check or Credit card/PayPal and is due once you have been accepted into a course.




12.    Training Agreement

You should only sign this assessment form if you agree to the terms and conditions on the  the  following statements and        

conditions as outlined below:


            “I understand that the Lightning Process is a training program.  It’s purpose is to train me in the tools of the Process, and I

            realize that simply attending will not guarantee me any results.  I recognize 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.”

       

            If sending the form via email, then please print your name if you would like it to represent your signature in this document.

       

            Signature:    _______________            Date:    ____________



           The following must be completed if you are under 18 years of age:

            Please ask you parent or guardian to read through the form and if they also agree to the terms and condition, please

            have them sign this form too:

               

            Name:    _________________________________


            Signature:   ______________________________       Date:  _______________


            Relationship to the applicant:   _______________



Terms and Conditions:

Once you have paid you have seven days to cancel your booking and receive a full refund if the course has not commenced.  After this the 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 grup 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 I 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 cost will not be accepted.


Ownership

All documents you receive as part of your training constitute the intellectual property of Phil Parker and are not to be reproduced, sold or distributed in anyway.


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 Register of Lightning Process Practitioners is registered with The Information Commissioners Office in London, England and all information is held in accordance with the Data Protection Act 1998.


You can decide to have your attendance certificate logged, together with your name, certificate number and e-mail 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 it’s associated programs.  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:   



Please send this completed form to:   Info@BeritFrivold.com   or mail to Berit Frivold,  11781 Nelson St.,  Loma Linda, CA 92354



Thank you for filling out this form,  I will be calling you shortly to discuss your training with you! 

I will confirm that I have received your application by email.





 
 Application formApplication_Form_files/Lightning%20Process%20Application.doc
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 Application formApplication_Form_files/Lightning%20Process%20Application_1.doc