Application form For the Lightning Process seminar
At The Parklands Clinic, Kettering, Northants.
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Am I ready to take the training?
Please complete this form first; it will help you to decide if you are ready.
Once you’ve filled it in and feel you are ready, please send it on to us. After we have received it you will be placed in our waiting list. (Unless you have already been given a date). When you reach the top of that list we will ring to talk to you before you take this training seminar in order to assess if this program is right for you right now.
The Lightning Process TM is a training program. Our experience is that if people apply the lessons of the Lightning Process TM to their lives they can start to change old patterns of thinking which in turn influences their health and happiness.
With any training program the trainer can only take responsibility for training and coaching to the best of their ability, then the student must apply the lessons for himself or herself. If the student doesn't apply the training, then they will naturally see very little benefit. We recommend that you think long and hard before taking this training, does it sound like something that appeals to you, and makes sense to you, something you can commit yourself to?
If you feel doubtful, cynical or just want to give it a go to see what happens, then now is probably not the right time for you - wait until you feel that way, ask others who've done the process, see what else is available or you will probably be wasting your time and money.
How the training is conducted.
Much will be demanded from you over the three days of the seminar, but if you take on the challenge, for which your trainer will assess you in terms of your readiness, the rewards are extraordinary.
Your trainer has a very demanding role during the seminars. They have to not only present the material but also manage and assist you as you go through that very challenging process. There are certain ground rules and understandings that will make the training easier for you and them:
Your trainer is completely committed to your success, as a result;
They won’t tolerate any behaviours that prevent you getting the success that you deserve.
They will deliver no-nonsense, honest and essential feedback, do not mistake this as not caring.
They will not always say what you want to hear.
If what you are doing is going to cost you your success they will tell you even if it risks you being annoyed with them.
That’s how committed they are to you and your success.
Your role in the training.
You will need to fill in the training agreement which is included in the application form below.
PLEASE MAKE SURE YOU FILL IN ALL SECTIONS
1. Agreement.
Please read these statements, and if you agree with them please circle the AGREE word, we will not accept you onto the training program unless all the statements are agreed to.
Our experience suggests you should only take the training if you agree to these statements:
I understand that the Lightning Process TM is a training program.
AGREE / DISAGREE
I understand that learning the Lightning Process TM does not guarantee me any results. AGREE / DISAGREE
I accept full responsibility for the effects of applying or not applying this training program to my life. AGREE / DISAGREE
I recognise that the mind and body can powerfully influence each other. AGREE / DISAGREE
I am prepared to look at and challenge my beliefs about my condition/illness, my health and myself. AGREE / DISAGREE
I am totally prepared to do the sometimes-challenging work of starting to think very differently that's required to get myself back on track.
AGREE / DISAGREE
2. Personal details and history.
Name
Name by which you wish to be called if different
Address:
Post code
Tel. home
Tel. work
Email
About you (this helps us to ensure the course is suitable for your needs, gives a sense of who you are);
Sex M F
Date of Birth
Occupation
What you hope to get from doing the course
How would describe your problems/issues/illness- (include medical name/ diagnosis if relevant)
When did your issues begin?
How did they start?
What effects has this had/how has this limited your life?
I know someone personally who's used the Lightning Process to recover their health YES/NO
3. Future.
When you have discovered a way to get well/ resolve my issues what will you put your energies into/what would you love to do with your life?
1
2
3
4
5
6
7
8
4. Readiness.
Overall, what score would you give yourself out of 10 for your belief that you can recover using the Lightning Process? _______
Please score each of the following out of 10, where 10 means “I totally agree with this statement.”
Statement one.
I want to resolve all my issues. _______
Statement two.
It is possible for me to resolve all my issues. _______
Statement three.
I am capable of learning how to resolve all my issues. _______
Statement four.
It is appropriate for me to resolve my issues and I am prepared to do what it takes to make those changes. _______
Statement five.
I am willing to change negative lifestyle patterns, thought processes and limiting beliefs. _______
Statement six.
I have the responsibility for resolving these issues and the power to do that. _______
Statement seven.
I deserve to and am valuable enough to resolve my issues. _______
Statement eight.
In terms of my issues and my ability to follow instructions, I am similar enough to all those others who have used the process to recover that I am bound to make the same kind of changes as them. _______
I am determined to be the next success story Yes/ No/ Maybe
5. The X factor.
Please write down a few sentences on what you feel is needed from YOU during the Lightning Process to get the changes that the others have achieved.
6. Please select one answer.
a) If you are presented with information do you tend to accept things as they are rather than tending to question them?
Yes No Other:
b) If others can get well using the process then so can I - do you agree?
Yes No Other:
c) My type of illness/issues (on which I want to use the process) are generally easily recoverable from.
It is definitely this way
Maybe true for some
I don’t know
Not true
d) My specific illness/issues are easy to resolve using the process.
It is definitely this way
Maybe true for some
I don’t know
Not true
e) My issues are different from other people’s ones.
It is definitely true
Maybe
I don’t know
Not true
Pair the words on the left with just one that has an opposite meaning.
Simple
Smooth
Difficult
Short
Complex
Soft
Rough
High
Tall
Can you suggest any improvements, or comments about the form.
Previous and multiple applications.
Have you applied to take the training before? YES NO (go to question 8)
If yes which trainer did you apply to………………………. And when…………
What has changed for you since applying to that trainer?
To process your application we will need to speak to that trainer about your case, please only send in the application form if you agree to this.
Please do not send in multiple applications to different practitioners.
8. Training Agreement.
Please read and if you agree to it, sign it.
I promise that during the training I will:
Deeply and honestly examine my beliefs
Be available for coaching at all times
Change anything that my trainer identifies as destructive
Be open to feedback of the trainer and my fellow trainees.
Recognise that I have blindspots that I don’t even know I have
Signature
Date
9. Payment details;
Fees for Lightning Process seminar with Georgina Block are £660. Please make cheques payable to Georgina Block.
Payment is by cheques or cash only.
Please send the payment with this form. We will not cash it until you have been booked into a course. If we decide that the course is not suitable for you at this point in time we will of course return your cheque.
Please ensure you fill this form in only if you are visiting the PARKLANDS CLINIC in Loddington, Kettering, Northants..
Conditions of payment
Once paid fees cannot be refunded in the event of a cancellation on your part, or a failure to complete the training; this is because we run small group trainings with limited spaces; if you take up a space and cancel, no one else will be able to fill it once the course starts. However, if you cancel at short notice and we are able to fill your space your fees will be refunded. We reserve the right to terminate your training if we feel your continued participation would be unhealthy or unhelpful for you or another member of the training group. Your fees will not be refunded in these circumstances.
Ownership.
All documents you receive as part of your training constitute an intellectual property and are not to be reproduced, sold or distributed in anyway.
If you agree to all of the above conditions in this document please fill in and sign the following declaration. I …………………………………….. understand and agree that once I pay my fees they cannot be refunded, that I understand the statements to which I have agreed and agree to adhere to the above conditions.
(signature)………………………………….
This must be completed if you are under 18 years.
If you are under 18 years age please ask your parent or guardian to read through the form and if they also agree to the terms and conditions, for them to sign the form too
Name………………………………………………………… Signature:
Relationship to applicant:
Date:
Thanks for helping us speed up your application by filling this out.
Please send to
Georgina Block
Parklands Clinic
4 Parklands Close
Loddington
Kettering
Northants
NN15 1LG