Weekly 60-Minute Telegroup
with Arinn Testa PsyD $159.00 every 4 weeks
I understand and agree that participation in EBT Connect™ and Emotional Brain Training (hereinafter referred to as "EBT") Support Training (Orientations, Groups, Telegroups, Intensives, Coaching, Telecoaching, Internet Community, Community, Retreats, Conferences, e-Learning Programs, and other seminars, workshops, apps, services and training) involves risk, including physical, physiological, emotional, social and psychological health risks. I also understand and agree that these risks may be increased by the dynamics of other participants in the group or program and the skill level of the EBT Provider (coach, group leader, group coordinator, educator or coach) in the application of EBT Support Training. I understand and agree that should I participate in EBT Support Training provided by audio conferencing or telephone, the risks may be greater than on-site programs because the EBT Provider conducting the training cannot see the participants and, therefore, may not be able to monitor a participantâ€™s true physical, physiological, emotional, social and psychological wellbeing. I understand that the 30-Day Challenge is an intensive intervention and the risks may be greater than weekly telegroups or other EBT Support Training. I understand that participating in the 30-Day Challenge involves acceptance that if a quorum of participants are not present at the starting of a session, the session will be canceled without a make-up session or credit in order to promote group cohesion. I understand that the safety and effectiveness of self-help and peer-to-peer applications of EBT are not known. I understand that it is the recommendation of The Solution Foundation and EBT, Inc. that all participants who have significant medical or psychological risks participate in professional medical or mental health treatment or counseling services in addition to or instead of EBT Support Training.
I understand and agree that EBT, Inc., The Solution Foundation or my EBT Provider may provide information about me (my first name, last name, telephone numbers and e-mail address) to the other members of the group, telegroup or community in which I am enrolled. I give permission to the staff of EBT, Inc., The Solution Foundation and Certified EBT Providers and their employees or agents to leave voicemail messages regarding my participation and administrative matters on all telephone numbers I provide to such parties and acknowledge and agree that such parties may identify themselves as from EBT, Inc., The Solution Foundation or the Certified EBT Providers' office. I acknowledge and agree that although participants in EBT Support Training are requested to preserve the confidentiality of other participants, there can be no assurance that such participants will do so or that my privacy or confidentiality will be preserved. Neither EBT, Inc., The Solution Foundation, its staff or Certified EBT Providers or their staff shall have any obligation to monitor or enforce compliance with the request for confidentiality by other participants. If I participate in EBT Support Training, any information I provide to other members is shared at my own risk and I acknowledge and agree that there can be no assurance that confidentiality will be preserved. I authorize EBT, Inc., The Solution Foundation and Certified EBT Providers and their employees, contractors and agents to discuss and to communicate freely to each other all information concerning me and my training available or known by any of them, and to disclose all such information (a)to attorneys or other professionals to accomplish the purposes for which such professionals are retained EBT, Inc., The Solution Foundation or Certified EBT Providers and (b) as may be required by law or legal process.
I understand and agree that if I do not comply with the member guidelines of this training, including using a nurturing voice toward self and others, give connecting messages after another person practices the skills, be positive, offering no judgments or criticisms, avoid intrusions, not interrupting or giving unasked-for advice, when appropriate making effective requests, staying focused, not mentioning other programs or products, and allowing for confidentiality and anonymity or my EBT Provider determines that my participation in EBT Support Training poses excessive risk to me or others, my participation in EBT Support may be discontinued. If that occurs, any fees that have been paid by me for past or current services are not refundable. I will not receive a credit or refund for the remaining prepaid meetings or other training. I understand that EBT, Inc., The Solution Foundation staff and Certified EBT Providers reserve the right to refuse service or participation in any activity to anyone at their sole discretion. I understand and agree that EBT, Inc., The Solution Foundation staff and Certified EBT Providers reserve the right to terminate my participation on the EBT Internet Community for any reason at their sole discretion, including if they determine that my participation poses excessive medical or psychological or other risk to other participants and/or members or me.
I understand and agree that although Certified EBT Providers may be licensed professionals (such as licensed mental health professionals, registered or licensed nutritionists or dietitians, licensed physicians, licensed nurse practitioners, certified coaches, certified health educators and related professionals), they are NOT practicing the professions for which they are licensed when facilitating EBT Support Training. I understand and agree that they are not providing medical, psychotherapy, nutritional, counseling or other treatment or therapy in any manner whatsoever, and their provision of EBT Support Training is EDUCATIONAL only. They are only training me in the concepts and tools of the method and are not providing any services covered in any manner by their discipline, licensure or registration as they provide EBT Support Training. I understand and agree that EBT, Inc., The Solution Foundation, Laurel Mellin, Walter B. Rose, Joseph R. Mellin, Sweetest Fruit Press, Harper Collins Publishing, Random House Group, Hay House, and the Regents of the University of California are not responsible for monitoring and ensuring the safety of EBT Provider services or their use of program training materials or compliance with any licensure or professional requirements or standards. I understand and agree that if for any reason my physical, physiological, emotional, social or psychological health is at risk during the period of my training, it is my personal responsibility to seek appropriate medical or mental health care immediately.
I understand that training sessions may be monitored for quality assurance or training purposes by a Certified EBT Provider or by EBT, Inc. or The Solution Foundation staff members. I hereby consent to their observation of any telegroup, or telecoaching in which I am a participant. I understand and agree that all services provided may be recorded by audio or video. These audio or video files may be used for quality assurance purposes and reviewed by a Certified EBT Providers or EBT, Inc. or The Solution Foundation staff members and may be used to create website, educational and informational programs including videos, audio tapes, written materials and other internet or website, educational and informational products for health or other professionals or the public. I understand and agree that the audiotapes of telegroup services in which I participate are posted on the member home page of all members of my telegroup until the next session occurs. When the next session occurs, the tape is no longer posted on the website and is not retained, except for audio or video files of EBT Support Training provided by Laurel Mellin, PhD, and EBT Trainers Michele Welling, MD, and Arinn Testa, PsyD which may be retained if they are selected for use in website, professional training, informational or educational programs. Any audio or video files of EBT Support Training in which I participate is shared at my own risk and I acknowledge and agree that there can be no assurance that confidentiality will be preserved. Participants in EBT Support Training are requested to preserve the confidentiality of other participants related to the audiotape or videotape EBT Support Training or other services in which I participate, but there can be no assurance that such participants will do so or that my privacy or confidentiality will be preserved. Neither EBT, Inc., The Solution Foundation, their staff or Certified EBT Providers shall have any obligation to monitor or enforce compliance with the request for confidentiality by other participants. I hereby consent to the audio and/or video taping of the services in which I participate and the use of audio or video tapes, files and transcripts for such website, educational and informational programs without payment of compensation of any kind, without prior notification of me and without any further agreement required by me.
I acknowledge that I have been given reasonable opportunity to ask questions regarding all these issues and risks, The EBT Program and EBT Support Training. I hereby assume all risks, including but not limited to those specifically mentioned in this release form. I also acknowledge that concerns, if any, regarding my participation in EBT Support Training have been resolved to my complete satisfaction.
I acknowledge and agree that other participants in EBT Support Training may include my spouse, family members, friends, or other persons with whom I have or may have had a personal or business relationship or conduct business with or have a personal relationship in the future, and that neither EBT, Inc., The Solution Foundation or any Certified EBT Providers shall have any obligation to consider such relationships or future relationships in admitting participants. I accept all risks of conflicts, disclosures, damages, injuries or harm of any nature that may result from such participation by me or other participants or the use of audio or video tapes, files and transcripts of my participation for such website and educational and informational programs. I will determine for myself whether there is any unacceptable risk of damage, disclosure, injury or harm and will withdraw or make other arrangements as I deem appropriate.
I do hereby waive and release all possible claims against EBT. Inc., The Solution Foundation, Laurel Mellin, Walter B. Rose, Joseph R. Mellin, Sweetest Fruit Press, HarperCollins Publishing, Random House Group, Hay House, the regents of the University of California, and Certified EBT Providers, Directors, and Staff from any and all claims or liabilities arising from or relating to my participation or the participation of any other person or persons in any manner in The EBT Support Training, including any activities, programs or transportation provided in connection with such training, activities or programs, or the use of audio or video tapes, files and transcripts of my participation for such website and educational and informational programs, including but not limited to damages, disclosures, injuries or harm of any nature whatsoever caused by third parties, including other participants, including but not limited to breaches of confidentiality or disclosures of private information about me or my participation by other participants. I understand and recognize that there are certain risks, dangers and perils connected with such participation, including but not limited to damages, disclosures, injuries or harm from other third parties, including disclosure of private information about me, which I hereby acknowledge have been fully explained to me and which I fully understand, and which I nevertheless accept, assume and undertake after inquiry and investigation of extent, duration and completeness wholly satisfactory and acceptable to me. I further agree to use my best judgment in undertaking these activities and to faithfully adhere to all safety instructions and recommendations, whether oral or written. I hereby certify that I am a competent adult assuming these risks of my own free will, being under no compulsion or duress. I hereby certify and represent that I do not suffer from any emotional, psychological, physical or medical condition that could make it unsafe for me to participate in The EBT Support Training. This waiver and assumption of risk is effective from start date of my participation in the program inclusive, and may not be revoked, altered, amended, rescinded or voided without the express prior written consent of EBT, Inc. and The Solution Foundation.
I voluntarily make and grant this waiver and assumption of risk in favor of EBT, Inc., The Solution Foundation, Sweetest Fruit Press, Laurel Mellin, Walter B. Rose, Joseph R. Mellin, HarperCollins Publishers, Random House Group, Hay House, and the University of California, as full consideration in addition to monies paid for the opportunity to use the materials and receive training from the personnel, consultants and affiliates of EBT, Inc. and The Solution Foundation.
THE EBT METHODS, COPYRIGHTED MATERIALS, CONFIDENTIAL INFORMATION, TRADE SECRETS AND TRADE AND SERVICE MARKS ARE USED ON AN "AS IS" BASIS. EBT, INC. AND THE SOLUTION FOUNDATION DISCLAIM ALL IMPLIED WARRANTIES FOR THE EBT METHODS, COPYRIGHTED MATERIALS, CONFIDENTIAL INFORMATION, TRADE SECRETS AND TRADE AND SERVICE MARKS, INCLUDING WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE. EBT, INC. AND THE SOLUTION FOUNDATION MAKE NO REPRESENTATIONS CONCERNING THE QUALITY OF THE EBT METHODS, COPYRIGHTED MATERIALS, CONFIDENTIAL INFORMATION, TRADE SECRETS AND TRADE AND SERVICE MARKS AND DO NOT REPRESENT OR WARRANT THAT THE EBT METHODS, COPYRIGHTED MATERIALS, CONFIDENTIAL INFORMATION, TRADE SECRETS AND TRADE AND SERVICE MARKS WILL PERFORM IN ANY SPECIFIED MANNER OR PRODUCE ANY SPECIFIED RESULTS. EBT, INC. AND THE SOLUTION FOUNDATION MAKE NO REPRESENTATIONS OR WARRANTIES CONCERNING WHETHER CONDUCT OF THE EBT PROGRAM WILL CONSTITUTE ACTIVITY REQUIRING OR NOT REQUIRING ANY SPECIFIC PROFESSIONAL LICENSE IN ANY SPECIFIC JURISDICTION. EBT, INC. AND THE SOLUTION FOUNDATION SHALL NOT BE LIABLE FOR ANY SPECIAL, INCIDENTAL OR CONSEQUENTIAL DAMAGES, EVEN IF INFORMED OF THE POSSIBILITY THEREOF IN ADVANCE. THESE LIMITATIONS APPLY TO ALL CAUSES OF ACTION IN THE AGGREGATE, INCLUDING WITHOUT LIMITATION BREACH OF CONTRACT, BREACH OF WARRANTY, NEGLIGENCE, STRICT LIABILITY, MISREPRESENTATION AND OTHER TORTS. (Any such limitation shall be inapplicable in any state to the extent such limitation is invalid under the law.)
The undersigned party and EBT, Inc., The Solution Foundation, Laurel Mellin, Walter B. Rose, Joseph R. Mellin, Sweetest Fruit Press, Certified EBT Providers, and their affiliates shall submit all disputes between them or relating to this EBT Support Training Release and Agreement (whether contract, tort, or both) to binding arbitration, in accordance with The California Code of Civil Procedure sections 1280 through 1294.2, as modified herein. Any party to the arbitration may enforce the award of the arbitrator under section 1285 of the Code. The parties understand that they are waiving their rights to a jury trial to the fullest extent legally permissible.
Before invoking the arbitration procedures set forth below in this EBT Support Training Release and Agreement, a party shall attempt to resolve the dispute through negotiation and, if necessary, mediation. The party shall first serve on the other party (a) a written notice of the claim, specifying the exact amount claimed and the authority or basis for the claim; and (b) a copy of all supporting documents. Within ten business days after service, the responding party shall serve on the serving party (a) a written response, setting out its position and specifying the document or other provisions relied on; and (b) a copy of all supporting documents. Within five business days after service of the response, the parties shall meet (in person or by telephone) to discuss resolution of the claim. Each party may bring up to three people to this negotiation. The written claim notice and response and the documents produced, but not the subsequent discussion, shall be admissible in any subsequent proceeding. After negotiation, either party may invoke the mediation procedure set forth below in this EBT Support Training Release and Agreement. Before invoking the binding arbitration procedure set forth below in this EBT Support Training Release and Agreement, the parties shall first participate in mediation of any dispute. The mediator shall be selected by mutual agreement of the parties. The mediation shall be held in Marin or San Francisco County, California
The mediation shall be conducted according to the rules of the American Arbitration Association. The cost of mediation shall be borne by the parties equally. At least ten business days before the date of the mediation, each side shall provide the mediator with a statement of its position and copies of all supporting documents. Each party shall send to the mediation a person who has authority to bind the party. If a dispute involves third parties, such as insurers or subcontractors, they shall also be asked to participate in the mediation.
If a party has participated in the mediation and is dissatisfied with the outcome, that party may invoke the arbitration provisions set forth below in this EBT Support Training Release and Agreement. The party demanding arbitration shall submit a written claim to the other party, setting out the basis of the claim and proposing the name of an arbitrator. The responding party shall have ten business days in which to respond to this demand in a written answer. If this response is not timely made, or if the responding party agrees with the person proposed as the arbitrator, then the person named by the demanding party shall serve as the arbitrator. If the responding party submits a written answer rejecting the proposed arbitrator then, unless the parties agree on an arbitrator, either party may apply to the American Arbitration Association for the appointment of an arbitrator. The American Arbitration Association shall propose five names. Each party may, within five days after receipt of the proposed names, strike two names from the list. Thereafter, the American Arbitration Association shall appoint as arbitrator a person whose name has not been struck from the list. The arbitrator shall be someone familiar with health and weight control and shall have at least ten yearsâ€™ experience in his or her field. No one who has ever had any business, financial, family, or social relationship with any party to the arbitration shall serve as an arbitrator unless the related party informs the other party of the relationship and the other party consents in writing to the use of that arbitrator. The arbitration shall take place in Marin or San Francisco County, California, at a time and place selected by the arbitrator. A pre-arbitration hearing shall be held within the ten business days of the selection of the arbitrator. The arbitration shall be completed and a decision rendered within 60 calendar days after the pre-arbitration hearing. The arbitrator shall establish any deadlines necessary to accomplish this goal.
Within 15 days after completion of the arbitration, the arbitrator shall submit a tentative decision in writing, specifying the reasoning for the decision and any calculations necessary to explain the award. Each party shall have 15 days in which to submit written comments to the tentative decision. Within ten days after the deadline for written comments, the arbitrator shall announce the final award. The arbitrator shall have the power to enter a default award if a party fails to participate in the arbitration. Before arbitration commences, each party shall pay the arbitrator half of the expected cost of the arbitration. A party that fails to pay its share shall not be allowed to participate in the arbitration. If a party fails to pay its share, the other parties shall pay pro rata the cost of the party that failed to pay. The arbitrator shall add such payment to the final award in such a fashion as to return the parties to the position they would have been in, to the greatest extent possible, if all had paid their share. At the conclusion of arbitration, the arbitrator may award the prevailing party some or all of the arbitration costs. The arbitrator may also award the prevailing party its, his or her expenses and fees of arbitration, including reasonable attorneys fees and witness fees, in such proportion as the arbitrator decides. No more than 30 calendar days before the arbitration, a party may serve a document request calling for any document that would be discoverable in civil litigation. The party served with this request shall deliver the requested documents and any objections within five business days. The arbitrator may resolve any dispute over the exchange of documents. Thereafter, each party may take no more than three depositions, each of which shall last no more than four hours each. The arbitrator may resolve any dispute over the depositions, as they would be resolved in civil litigation. The arbitrator shall have the following powers, subject to the provisions of this EBT Support Training.Release and Agreement:
Despite any statute to the contrary, any claim arising from or relating to this The EBT Support Training Release Agreement or The EBT Support Training against the undersigned party, EBT, Inc., The Solution Foundation, Laurel Mellin, Walter B. Rose, Joseph R. Mellin, Sweetest Fruit Press, HarperCollins Publishing or Certified EBT Providers or their affiliates (whether contract, tort, or both) shall be brought within one year after it arises; provided that any mediation undertaken by the parties under the mediation provisions set forth above in this EBT Support Training Release and Agreement shall toll the time period within which the claim must be brought. This EBT Support Training Release and Agreement, and any dispute arising from the relationship between the parties to this EBT Support Training Release and Agreement shall be governed by California law, excluding any laws that direct the application of another jurisdiction's laws. To the maximum extent possible, any arbitration under this EBT Support Training Release and Agreement shall be consolidated with any arbitration proceeding in which related issues are being resolved. The parties shall take all action necessary or desirable to achieve consolidation.