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Following are some details of how I work with clients. Please complete, sign and submit on-line. If you have any questions, please call me. I expect lots of growth and positive changes to come to you; I ask you to expect the same! We’ll work together to unblock anything that’s stopping your success, and unlock the potential we all have for a fulfilling life. Change is always possible, and that’s what I’ll help you to do.

Becca Williams | Guide & Mentor: Emotional Liberation                              

Welcome! I am glad to be working with you.

RELATIONSHIP We are entering into a collaborative relationship dedicated to your growth and accomplishment. Coaching is not about me having all the answers, but about my helping you discover your own. We will build trust. I will challenge you, but this should always feel safe and unconditionally supportive. Of course our work is completely confidential.

CALLS Our calls or visits are typically 80 minutes and scheduled mutually or from the “Private Sessions” link on my website. Our agreement may include one or more sessions per month, and can be changed by either of us at the completion of the last paid session or series. Choose your initial number of sessions or after we meet and discuss, we can decide together. You can book sessions at: LINK Here.

CHANGES Dates can be adjusted to either of our needs with prior notice. Please give me at least 24-hour notice to reschedule. I will do the same. If you must cancel a call, we will reschedule soon to maintain your monthly frequency. No show with no notice is acceptable only as an exception and may be charged. Use your sessions in the agreed up timeframe; no refunds.

FEE & TERM See my fee schedule for pricing and discounts for multi-month commitments. I recommend you plan for a minimum of 9 sessions, up to 12 months of coaching to see permanent changes in you and your circumstances, though there is no minimum. Payment is on-line (LINK HERE) by PayPal or credit card and is due in advance of your series. I request 30 days notice to discontinue your work with me, so we can finish our work in a mutually powerful way.

EXTRA TIME Being here for you is part of our relationship. You may call or email me anytime and I do my best to respond appropriately to the urgency you convey. I do not bill for occasional additional contact, but will alert you if frequency or length of calls is such to become billable time.   Personal cell  727-510-9163; leave a detailed message if I do not answer. E-mail contact is encouraged anytime: Becca@cannanaut.com.

I, the undersigned, agree that I am personally responsible for the actions I take as a coaching client.  As such, I do not hold Becca Williams, Cannanaut nor its affiliates liable for consequences of my actions, or lack thereof.  I understand that Becca Williams is a professional Life Coach, Registered Dietitian & Nutritionist and certified in Emotional Liberation, and is not an Employment Agent, Business Manager, Financial Consultant, Psychotherapist, nor Counselor.
 

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Billing Address

Billing Address *
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Billing Address

Billing Address *
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Billing Address

Billing Address *
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Billing Address

Billing Address *
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Billing Address

Billing Address *
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Billing Address

Billing Address *
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Billing Address

Billing Address *
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Billing Address

Billing Address *
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Billing Address

Billing Address *
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Billing Address

Billing Address *
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
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Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Billing Address

Billing Address *
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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