Mentorship Program

Don't forget to click the 'Pay Here' button to pay for your mentorship after you submit this form.

All coaching services and communication email or otherwise, delivered by Purpose and Resilience as well as information on this website purposeandreslience.net are meant to help you identify the areas in your life and in your thinking that may be standing in your way. However, coaching is not professional mental health care or medical care. If you feel psychologically stressed to the point that it is interfering with your ability to function, please have the courage to seek the help you need in the form of a professional counsellor. Coaching may augment your therapy, but the work of coaching is meant to be done when major emotional and psychological wounds are already healing or healed. In that spirit, by purchasing coaching services from Coach Purpose, you confirm that you have read and agreed to each statement and that you wish to proceed: I understand that the coaching services I will be receiving from Coach Purpose are not offered as a substitute for professional mental health care or medical care and are not intended to diagnose, treat or cure any mental health or medical conditions. I also understand that Coach Purpose is not acting as a mental health counsellor or a medical professional. I understand that coaching is, at present, an unregulated industry and that Coach Purpose is not licensed by any internationally recognized regulator. I also understand that for all legal purposes, the services provided by Coach Purpose will be considered to be provided from any remote location worldwide or otherwise in the United States. I understand and agree that I am fully responsible for my well-being during my coaching sessions, and subsequently, including my choices and decisions. I understand that coaching is not a substitute for counselling, psychotherapy, psychoanalysis, mental health care or substance abuse treatment, and I will not use it in place of any form of therapy. I understand that all comments and ideas offered by Coach Purpose are solely for the purpose of aiding me in achieving my defined goals. I have the ability to give my informed consent, and hereby give such consent to my coach to assist me in achieving such goals and aims. I understand that to the extent our work together involves career or business, Coach Purpose is not promising outcomes included but not limited to increased clientele, profitability and or business success. I understand that Coach Purpose will protect my information as confidential unless I state otherwise in writing. If I report child, elder abuse or neglect, or threaten to harm myself or someone else, I understand that necessary actions will be taken and my confidentiality agreement is limited in this capacity. Furthermore, if Coach Purpose is ordered by a court to provide information or to testify, he will do so to the extent of that the law requires. I understand that the use of technology is not always secure and I accept the risks of confidentiality in the use of email, text, phone, and other technology. I hereby release, waive, acquit and forever discharge Coach Purpose, any agents, successors, assigns, personal representatives, executors, heirs and employees from every claim, suit action, demand or right to compensation for damages I may claim to have or that I may have arising out of acts or omissions by myself or by Coach Purpose as a result of the advice given by Coach Purpose or otherwise resulting from the coaching relationship contemplated by this agreement. I further declare and represent that no promise, inducement or agreement not expressed in this agreement has been made to me to sign this agreement. This agreement shall bind my heirs, executors, personal representatives, successors, assigns, and agents.

• That I have read or had this form read and/or had this form explained to me • That I fully understand its contents including the risks and benefits of coaching. • That I have been given ample opportunity to ask questions and that any questions have been answered to my satisfaction.