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Registration for
ASAT™ C.O.R.E. Counseling Courses

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Name *

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Address *

Course Option *

3 Weekend Training Course - $2,500 3 Weekend Webinar Training - $2,500 ASAT C.O.R.E. Processing Workshop - $350

City *

State *

Method of Payment *

Paypal - coming soon Check - see below for mailing address Credit Card - call in credit card number, see below for phone number

Zip Code *

Phone *

Email *

Occupation *

Agreement and Release

I understand that the materials and titles in this course are trademarked and copyrighted and therefore protected under Federal Law. I agree not to use information from the ASAT™ C.O.R.E. Counseling course to in any way violate trademark and copyright laws or any medical practices act, and will conduct my practice according to existing laws and regulations governing said practice. I understand that once the course begins, all payments made, full or partial, are nonrefundable. I HAVE BEEN DULY INFORMED BY ASAT™ THAT SOME PARTICIPANTS MAY FIND THE COURSE TO BE AN INTENSE EXPERIENCE, PHYSICALLY, MENTALLY, AND EMOTIONALLY. I WARRANT AND REPRESENT THAT I AM PHYSICALLY, MENTALLY AND EMOTIONALLY ABLE TO ATTEND THE COURSE AND AM NOT CURRENTLY SUFFERING FROM, TAKING MEDICATION OR BEING TREATED FOR ANY MENTAL ILLNESS OR EMOTIONAL DISORDER WHICH ILLNESS OR DISORDER WOULD BE ADVERSELY AFFECTED OR OTHERWISE AGGRAVATED BY MY PARTICIPATION IN THIS COURSE. IN ANY EVENT, I HEREBY WAIVE, remiss, release, and forever discharge for myself, my successors, heirs and assigns the said Dr. Martin Hart, individually, and ASAT™ and its successors, assigns, officers and directors, of and from any and all causes of action, suits, contracts, controversies, agreements, promises, damages, judgments, executions, claims and demands, whatsoever, in law or in equity, which against the said Dr. Martin Hart or ASAT™ I ever had or now have or which my successors, heirs or assigns hereafter can, shall or may have for, upon or by reason of any matter or thing whatsoever from the beginning of the world to the date of these presents and more specifically those claims arising out of the above described ASAT™ C.O.R.E. Counseling course. This release may not be changed orally.

Checking the "I agree" box is required for acceptance to the course.

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By checking the "I agree" box and typing your name below you agree to the terms and conditions *

Submit

3 Weekend Training

2,500.00

Video Conferencing Training

2,500.00

                         To call in credit card information please call - (978) 561-1639

                       Please make checks payable to:
              ASAT Press
             69 Washington St. Suite 10A
                                                Topsfield, MA 01983
                                                            USA

Registration for ASAT™ C.O.R.E. Counseling Courses

Fill out this form completely and click submit

Registration for
ASAT™ C.O.R.E. Counseling Courses