A Year to Change Your Life Application

Date *

Name *

First

Last

Date of Birth *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Primary Phone Number

Alternative Phone Number

Email *

How did you hear about A Year to Change Your Life *

Are you currently under a physician's care? *

Yes
No

Please provide a brief explanation: *

Are you currently taking any medications and/or supplements? *

Yes
No

Please list below: *

What is compelling you to pursue a workshop like “A Year to Change Your Life” at this point in your life? *

What skills and personal attributes will you bring to this experience? *

What do you hope to gain from taking part in A Year to Change Your Life? *

How do you see yourself as being a source of support and inspiration to the other participants? *

Are there any obstacles that may interfere with your progress in A Year to Change Your Life or could prevent you from completing the course? *

How did you hear about A Year to Change Your Life? *

If "other," please specify: *

Is there anything else you would like us to know? *

Agreement

I certify that the above information is true and complete to the best of my knowledge and that I will not hold CALM Living Studio, David Kantra, Augusta Kantra, or any guest presenters liable for any mishaps arising from my participation in A Year to Change Your Life.

Signature *

Date *

Payment Options

Please choose one: *

Option I: Full payment (after December 15, 2020). $2950 pay in full upon acceptance of application. ($250 discount)
Option II: Payment plan — $3200: You will pay $500 deposit with application plus 4 monthly payments of $675 due of February 1, Mar 1, April 1 and May 1, 2021. A weekly late fee of $50 will be applied for any late payments.

A $500 non-refundable deposit is due with your application:

Price: $ 500.00

Credit Card *

Card

Name on Card

Refund Terms & Conditions

I understand and agree that if I cancel my enrollment at least 60 days before the beginning of my program, I will be entitled to a refund of amounts paid, less $500. I understand and agree that if I cancel my enrollment less than 60 days before the beginning of my program, or if I do not complete the program for any reason other than cancellation of the program by Augusta and David Kantra, I will not be entitled to any refund, and will be obligated to pay any remainder of the enrollment fee designated above. This agreement shall be governed by the laws of the State of Alabama without regard to any law that directs the application of the law of another jurisdiction.

Signature *

Date *

A 12-Month Inquiry into Your Life, Your Heart, and Your Future

All applications will be accepted until spaces are filled.

Your Commitment
Your acceptance into the program assumes you are making this program a priority in your life. This training will require a sincere commitment to the process, and full participation is essential not just for you, but also for the benefit of the other YTCYL attendees. If your attendance drops below 80%, we’ll have a conversation about your intention and what you need to stay engaged. If your participation remains low, you may be asked to withdraw. Please carefully consider whether you can make this commitment. If you decide to drop out after the first month, you will still owe the full tuition. Commitment to the process, and sincerity of heart are the two most important attributes to bring to this experience. If you feel called to take part but are concerned you may be weak in either of these areas, please contact us and we can discuss your concerns. We are excited about this new course offering. It is the culmination of an idea we first explored in 2009, and have diligently designed and developed since that time. We promise to bring our best to every meeting as well as a strong dedication to helping each participate find his or her path to a better future.

Signature *

Date

A Year to Change Your Life Registration

Agreement

Payment Options

Refund Terms & Conditions

A 12-Month Inquiry into Your Life, Your Heart, and Your Future