The Going Home Workshop remains an evolving training program of the Monroe Institute. The Outreach Trainer(s) retains the right to determine if I may or may not continue with the sessions and Program. If he or she deems me unsuited for continuation in a session or in the whole program, he or she will return the balance of my fee on a pro-rated basis.

In consideration of the mutual benefits which are expected to arise out of the activities in which I intend to engage which are designed by the Monroe Institute, and especially the educational and other benefits which I expect to derive, I release the Outreach Trainer(s), the Monroe Institute and all related persons, from all claims and demands which I have, or may have, against them by reason of any injury of any nature which I might suffer as a result of such activities. I declare that I enter into these activities voluntarily in an effort to increase my knowledge of the subjects under investigation.

I am providing my mailing and email addresses because I want to receive discounts and program offers for future Monroe programs, and I ask that my Outreach Trainer forward this information to the Monroe Institute. By providing this information, I understand that my data will only be used to inform me about upcoming offers and for internal data analysis. The Monroe Institute will never forward or sell my information to any third party.

Do not share my information: {field:do_not_share_my_information_1787816575064}

Signature: {field:signature_1787816613676}

Date: {field:date_1787816702776}

Name: {field:name_1787816739188}

Phone: {field:phone_1788220898971}

Name you like to be called: {field:name_you_like_to_be_called_1787816760941}

Email: {field:email_1788220969893}

Address: {field:address_1787816774328}

City: {field:city_1787816787836}

State: {field:state_1787816910943}

Country: {field:listcountry_1787816943487}

Postcode: {field:postcode_1787817189839}

TMI sourses completed: {field:tmi_courses_completed_1787817011277}

Other self-development courses taken: {field:other_self-development_courses_taken_1787817110122}

Workshop dates: {field:workshop_dates_1787817061759}

Workshop Location: {workshop_location_1787817137779}

Outreach Trainer: {field:outreach_trainer_1787817827416}

GDPR