Name *

First Name

Last Name

Are you 18 years or older? *

Yes

No

How did you hear about Mary? *

Facebook

Internet

Word of mouth

Friend or colleague

Other

WAIVER * 1. Privacy policy: The students’ information will be kept private. The materials given out in Mary's lessons and any recordings both video and audio that are made during lessons are restricted from all social media and for private use only. 2. Participants agree that they are of sound body and mind. They understand that the class format includes emotional work and there may be profanity used. The participants will not sue for emotional or physical damage. 3. Mary and her team are not responsible for lost or stolen items or damage to their property. *

I AGREE