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Click below to submit your form. You will be taken to the Checkout page, however, if you prefer not to pay online, simply call or email the office with your credit card information. Please note that even if you do pay online, we will need to have your credit card information on file for your subsequent payments.

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Intuition and Subtle Energy for Relationships and Health

Class Series Registration and Agreement

Please read the below agreement and sign at the bottom to acknowledge that you understand and agree to the terms and conditions.

TUITION: I understand that by signing this registration agreement I am making a contract with Astrid Pujari, MD, PS that I will pay monthly installments of $159.00 for the 9-month duration of the class or pay in full $1431.00.  

  • If paying in full I agree to make the $1,431.00 payment at the time of registration.

  • If paying monthly I agree:

    • that starting April 1, 2024, and ending November 1, 2024, my credit card will automatically be charged a $159.00 monthly installment on the first day of each month, and

    • that if I do not place a valid credit card on file at least 48 hours prior to the class date, my registration in the class will be rescinded.

  • I understand that my tuition includes 9 classes over 9 months.  

  • I agree to pay the full amount of tuition, regardless of how many classes I attend or do not attend, regardless of circumstances. If I decide to cancel my attendance in the course, I agree to put my request in writing and on the day of my written request, I agree to pay in full the remaining amount of tuition at that time.

 

ZOOM: I understand that this class will primarily take place over Zoom only and that I am solely responsible for ensuring that I have a working Zoom account, that I either know or will learn how to use Zoom, and that I will ensure that my Zoom is working prior to the class. 

I hereby authorize Astrid Pujari, MD, ABIHM (aka Dr. Pujari), and those acting pursuant to her authority a nonexclusive grant to:

  • Record my likeness and voice via Zoom during any and all “Intuition and Subtle Energy for Relationships” classes (“CLASS”), as applicable. 

  • Use my name in connection with any and all CLASS recordings.

  • Use any and all CLASS recordings without compensation to myself or any other party.

  • Distribute any and all CLASS recordings at any time, to any individual that that Dr. Pujari deems appropriate, and who has signed a confidentiality agreement prior to receiving the recording stating that they will not divulge personal information contained therein, nor distribute the recording in any capacity.

IN-PERSON CLASSES:

I agree that I am solely responsible for any and all travel arrangements, weather precautions, Covid precautions, and any issues that may arise regarding my attendance for any class taking place in person. I also agree that I will not hold Astrid Pujari MD, ABIHM accountable for any injury, illness (including, but not limited to Covid), loss of property, or any other hardship I may incur during an in-person class. I understand that any and all in-person classes will not be recorded and that if I miss an in-person class I am solely responsible for obtaining information about the content of that class.

 

MISSED CLASSES: I understand that there may or may not be a video or audio recording of classes held on Zoom that I can access afterward if I miss any, and that in-person classes will not be recorded. I also understand that there will be no make-up classes, that I will be charged for all classes regardless of attendance, and that if would like information about the content of a missed class I am solely responsible for obtaining it. I understand that I am responsible for knowing the dates and times of all classes, and that any and all classes may be rescheduled by Dr. Pujari with advance notice.

 

CLASS CONTENT: I understand that this class is intended for spiritual education only and is not intended to diagnose or treat any illness or provide any medical advice, diagnosis or treatment. I will hold Astrid Pujari, MD harmless for any information provided. 

 

CONFIDENTIALITY: I understand that the dynamic of the group lends to an open and intimate sharing of personal information and I can share or not share within my level of trust and comfort, without expectation. I also understand regardless of my contribution, confidentiality is of the utmost importance and I agree to not share personal details that are shared during class with anyone outside of the group.

I understand the following:

  • The distribution of any and all CLASS recordings is for educational purposes only; they will not be used for promotional or advertising efforts, or any other commercial endeavor. 

  • No CLASS recordings will be edited; they will be distributed exactly as recorded. 

  • Any information I share is at my sole discretion, and I will not be given the opportunity to edit or redact this information from any and all recordings. 

  • Any and all CLASS recordings shall remain the sole property of Dr. Pujari.

  • Failure to sign this agreement may prohibit my participation in this class if a satisfactory alternative accommodation cannot be made.

I agree that:

  • I will not share harmful or malicious information during any CLASS, or take any other action that could compromise the usability of any CLASS recording. 

  • I will not hold Astrid Pujari, MD and those acting pursuant to her authority responsible for any aspect of my participation in any CLASS, nor on the resultant recordings.

  • If I am given access to any CLASS recordings, I will not share them with anyone outside of the class, and I will delete them after viewing.

  • I hereby release Astrid Pujari, MD and those acting pursuant to her authority from liability, claims, and demands for any violation of any personal or proprietary right I may have in connection with such use, including any and all claims for libel, defamation, or invasion of privacy. I have read and fully understand the terms of this release.

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