I am fully informed to my satisfaction about Momentum Education’s courses and willingly choose to participate in one or more of their courses.
I understand that Momentum Education’s courses are experiential, philosophical, and educational and that they may or may not assist in my personal growth. It is not intended to be psychotherapy or medical therapy or a substitute for either one. Momentum Education trainers are not licensed therapists or psychologists. I further understand that some of the processes involve sharing and I may experience deep emotions and possibly emotional stress, anxiety, tears, physical discomfort or exhaustion.
I understand that Momentum Education, its employees and volunteer members, will assist me and are responsible only for presenting the program in an orderly manner. Momentum Education is not my fiduciary and I do not expect the courses to be administered with the standard of care expected of trained mental health professionals. If I feel mental or physical discomfort or adverse effects during the program, I promise to inform the trainer or staff immediately. I understand that I am free to leave the program at any time for any reason. If I feel I need assistance from anyone, professional or otherwise, I take full responsibility for leaving the program and obtaining it for myself.
I agree that Momentum Education, its agents, employees and volunteers, shall not be liable to me for any injury or damage, however caused, resulting from my participation in the Momentum Education curriculum, and I hereby discharge Momentum Education, its agents, employees and volunteers from all actions, claims, and demands I may have for any such injury or damage.
Momentum Education workshops are beneficial for the vast majority of participants in terms of increasing personal effectiveness and overall satisfaction in life, but should not be taken to resolve emotional problems for which therapy or similar treatments are generally used.
The courses are experiential and designed to enhance personal effectiveness. It is not intended to be psychotherapy or counseling or an alternative to psychotherapy, therapy, or any kind of counseling. Momentum Education is not a psychological support group or a therapeutic environment.
Momentum Educations’ trainers, consultants, employees and volunteers are not trained mental health professionals and they are not trained to treat psychological problems or to provide treatment to an emotionally or psychologically distressed person.
While it is ultimately your choice, OUR ADVISORS STRONGLY RECOMMEND THAT YOU SHOULD GET MEDICAL CLEARANCE TO PARTICIPATE in Momentum Education Programs if you:
(a) have a personal or family history of bi-polar affective disorder (manic-depressive disorder), schizophrenia, acute or chronic depression or other psychotic disorder, whether or not you or they are being or have ever been treated or hospitalized;
(b) are taking, have taken or been prescribed to take within the previous twelve months anti-anxiety drugs (such as Librium, Ativan, Klonapin, Xanax, Dormicum or others); anti-depressants (such as Elavil, Prozac, Zoloft, Celexa, Cipram, Prothiaden or others); anti-psychotics (such as Thorazine, Haldol, Stelazine, Risperdal, Zyprexa, Dogmatil or others); any medication to treat bi-polar disorders (such as Lithium, Gabapentin or Depakote); any drugs or medicines, whether prescription or non-prescription, intended to treat or affect mental processes or mood or to treat a chemical imbalance; or anabolic steroids;
(c) have an unresolved history of drug or steroid abuse;
(d) are or have in the past year been depressed and/or considered or had ideas of suicide, self-harm or harm to another;
(e) are currently in therapy and your therapist sees a health reason why you should not participate in the Program; or
(f) are uncertain about your physical, mental or emotional ability to participate in the Program.
People who mistake Momentum Education workshops for an alternative to therapy may experience adverse consequences. If you have, or believe you may have a problem requiring psychological treatment, please do not attend any Momentum Education workshops. We urge you to consult a qualified professional.
By signing the registration form, you will be agreeing to assume full responsibility for your participation with Momentum Education and agreeing not to sue Momentum Education.
Momentum Education trainers reserve the right to prohibit or remove people from its courses for any reason. In such instances, Momentum Education will refund your tuition.
I hereby acknowledge and attest that I am over 18 years of age, and I have thoroughly and carefully read the information contained herein. I understand it, and I have answered all the questions fully and truthfully. I am fully responsible for my participation with Momentum Education.