Attendee Information Name*
First
Last
Email* Best Way to Contact Me: Address*
Date Attended PSI-7 Life Success Course* Do you have any special dietary needs?*
Terms and Conditions This field is hidden when viewing the form
Are you pregnant?* This field is hidden when viewing the form
Do you have any history of psychiatric disorder, been institutionalized for mental illness within the last 12 months, or undergone treatment by a psychiatrist or psychologist in the last 6 months?* Please explain any of the above marked "yes"*
Are you a resident of the state of Hawaii?* PSI ADVANCED SEMINAR ATTENDANCE ELIGIBILITY* All course prerequisites must be completed prior to attending.
Health and Safety -
you may not attend in-person Advanced Seminars while pregnant.
PSI Seminars are based on an educational model, not a medical model. Please be advised that our Seminars are not intended as a replacement for mental health treatment or services.
If you have any history of psychiatric disorder or have been undergoing treatment by a psychiatrist within the last six months, it is the policy of PSI Seminars that you NOT attend. Direct any questions regarding this policy to
[email protected] I have read, understand, and agree to the PSI Eligibility Requirements
Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19* The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious and is believed to spread mainly from person-to-person contact.
PSI WORLD, AND PSI SEMINARS, LLC strongly recommends vaccination prior to attending any seminars and/or indoor gathering.
PSI WORLD, AND PSI SEMINARS, LLC has put in place preventative measures to reduce the spread of COVID-19; however, PSI World and PSI Seminars cannot guarantee that you will not become infected with COVID-19. Further, attending our seminar could increase your risk of contracting COVID-19.
By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by attending a PSI Seminar’s event and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 at the seminar may result from the actions, omissions, or negligence of myself and others, including, but not limited to, PSI employees or staff, volunteers, and program participants and their families.
I voluntarily agree to assume all of the foregoing risks and accept sole responsibility for any injury to myself (including, but not limited to, personal injury, disability, and death), illness, damage, loss, claim, liability, or expense, of any kind, that I may experience or incur in connection with my attendance at, or participation in PSI Seminars (‘Claims”). On my behalf, I hereby release, covenant not to sue, discharge, and hold harmless PSI, its employees, agents, and representatives, of and from the Claims, including all liabilities, claims, actions, damages, costs or expenses of any kind arising out of or relating thereto. I understand and agree that this release includes any Claims based on the actions, omissions, or negligence of PSI World or PSI Seminars, its employees, agents, and representatives, whether a COVID-19 infection occurs before, during, or after participation in any PSI Seminars program.
I have read, understand, and agree to the Assumption of the Risk and Waiver of Liability Relating to Coronavirus/COVID-19
PSI SEMINAR TUITION POLICY* PSI Package Tuition Policy:
If purchasing two or more courses in a single transaction (package), the tuition for the first course must be utilized within 6 months from date of registration or will be forfeited. Subsequent course tuitions must be utilized within 12 months from date of registration or will be forfeited.
PSI Advanced Seminar Tuition Policy:
Tuition must be paid in full prior to attending. All tuition payments are non-refundable and must be utilized within 6 months of the date of registration or will be forfeited. Changing your attendance date within 30 days of your scheduled class is subject to a $1000 fee.
Tuition Transfer Policy:
In the event you are unable to attend, you can make a one-time transfer of the full amount of your paid tuition to another student. Transferred funds will be converted to a non-refundable single-use voucher that can be applied to any full price seminar purchase. Transfer voucher must be redeemed within 30 days or will be forfeited.
PSI-5 Tuition Policy:
Payment for PSI-5 is non-refundable. Your purchase must be applied to the soonest available PSI-5 date and is not valid for any other classes or future dates. Not for resale.
Cancellation, Date Changes, and Transfer Requests will be subject to an administrative fee of $500. If any of these requests fall within 60 days of the scheduled event, those requests will be subject to an administrative fee of $1500.
Class size is limited, and payment in full does not guarantee a seat in the class. If the class is at capacity you will be placed on a waitlist. Once your registration is complete a representative will contact you to confirm your status.
Canada:
I understand that PSI Seminars Canada is governed by the Provincial Consumer Protection Acts. Furthermore, I understand that my payment for any PSI Advanced Seminar is non-refundable and must be utilized within 6 months of the date of registration or will be forfeited.
HAWAII WAIVER* The law in Hawaii is drafted to protect those who deposit money to attend a sensitivity awareness group seminar by granting the student the right to cancel the course before the first day of the course and obtain a refund of sums paid less $50. We have the obligation to disclose this right to you.
However, PSI Seminars limits its enrollment positions for the class. Once the class is full, expenses for providing the course become part of the overall budget for the presentation of the class, including but not limited to, transportation and lodging of the students, food preparation and presentation, materials, supplies, and all other related costs which are fixed. Unfortunately, if any student should request and demand a refund, the financial domino effect upon those who do attend will be felt. The costs of the course are kept at a minimum to make it accessible to as many as possible.
In order to be fair, PSI Seminars requests those who are residents of Hawaii to waive the protections otherwise provided under law, and accept that the commitment to attend the seminar will be relied upon by others financially, and that the enrollment fee is part of the fixed cost of presenting the seminar for all members. By registering below the student waives the refund rights accorded by the laws of the State of Hawaii.
I waive my entitlement to a refund under Hawaii law.
Registration Details PSI Leadership Seminar USA*
Complete Your Registration Package Initial Payment* Your installment plan begins when you register with your non-refundable initial payment of $2,000, which will be charged to your credit card immediately.
Package Monthly Payments* Following your initial payment of $2,000, you will be charged each month on the same day of the month until your balance is paid in full. The total of all payments on the installment plan will be $11,095 including your initial payment today.
Leadership Seminar Payment Plan* Your monthly payments will start in 30 days and you will be automatically charged each month.
Leadership Seminar Payment Plan* Your monthly payments will start in 30 days and you will be automatically charged each month. Your total tuition paid after completion of all payments will be $7,500 USD.
Registration Code Terms* Please note: Use of registration codes (coupon/promotional codes) is at the discretion of PSI Seminars. If it is determined that the registration entry does not qualify for the code used, you may be responsible to pay the difference in tuition before attending your course.
I agree to the Registration Code Terms
Installment Plan Terms* I understand that my credit card will be initially charged for my deposit and the same credit card will be used for all subsequent installment plan payments.
I agree to the Installment Plan Terms