Membership for Remote Services

To ensure a seamless EERemote session experience, we kindly request that all participants sign the waiver and membership application, as well as complete the questionnaire and upload photos for each individual taking part in the session. This information will help us tailor the session to your specific needs and maximize its effectiveness. Once approved, you'll be able to embark on a journey of healing and self-discovery like never before.

Waiver & Membership Agreement

Please access our Waiver and Membership Application for download, fill-out the questionnaire, upload photos, and sign the online form below for each participant, and submit it by clicking the designated button to initiate your membership process.

Remote Member Information

First name

Last name

Phone number

Connection to God (Rate from 1 to 5, None to Fully Connected) *

Energy Level (Rate from 1 to 5, Low to Great) *

How is your sleep? (Rate from 1 to 5, Poor to Great) *

Stress Level (Rate from 1 to 5, Low to High) *

What challenges do you face that you want to improve?

Please upload passport style photo with a blank, light colored wall. Please do not wear a hat, glasses or patterned clothing. Please copy example.

Upload File

Upload supported file (Max 15MB)

I agree to the Membership Terms & Conditions as stated in the Membeship agreement.

I agree to the Waiver terms & conditions

Your Signature

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