Please take your time filling out the questions below.  They are intended to support you in getting clear on what you want to accomplish in this Experience and to let us see if what you want to accomplish is a match for the program. If this program is not a match, we will let you know and will refund your tuition. So, please be as authentic as possible so we can be sure this program is a match for what you want and need.  Thank you. 

> Kay & The Peak Awakening Team

The following questions are specifically worded to evoke curiosity, wonder and intention with regards to your participation in The Mentally & Soulfully Grounded Experience.

Please write down the answer that first comes to mind, no holds barred. Do not judge what you write; instead, let it flow through you. You might actually be surprised by what you say!

This Experience will result in the fulfillment of what you write below.

Please record your attendance as best as you know it right now.  If your attendance changes, we will tell you what to do about it in the first session.  

(NOTE: If you are doing the extra 30 minute pre-certification training at the end of each session, please do not indicate that on this form.  We will deal with that at a later date).

After you submit this form, you will be redirected to a page where you can sign a Liability Waiver and Confidentiality Agreement.  You are not considered approved for the program until these forms are signed. 

Thank you.