Registration

Step 1 of 4

You will select the course(s) or group(s) you wish to register for on Step 4 of the Registration form.

Name(Required)

First Last

Email(Required)

Phone

Address(Required)

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Recording Information and Release

We record all trainings for internal use and development, and we sometimes use screenshots or training segments for marketing. Recordings are not available to participants and are not distributed publicly except as described. Small group breakout room exercises are not recorded during the training. If you have any questions regarding the recording release, please contact alison@mostenguthrie.com.

By executing this form and participating in the Mosten Guthrie 40-Hour Family and Divorce Mediation Training, you hereby consent to the recording and distribution of reproduction(s) of your voice and image as a participant in the training program. You hereby acknowledge that Mosten Guthrie Academy is the sole owner of all rights in and to the training program, and the recording(s) thereof, for all purposes; and that Mosten Guthrie Academy has the unfettered right, among other things, to use and distribute the recording(s) of the training program, or any portion thereof, and your video and/or audio as embodied therein, together with your name, professional information, photograph or likeness (including, without limitation, any photographs or other material provided by you).

Recording Notification and Consent(Required)

By executing this form and participating in the Mosten Guthrie Training or Group, you hereby acknowledge and consent to the recording and distribution of reproduction(s) of your voice and image as a participant in the training program. You hereby acknowledge that Mosten Guthrie Academy is the sole owner of all rights in and to the training program, and the recording(s) thereof, for all purposes; and that Mosten Guthrie Academy has the unfettered right, among other things, to use and distribute the recording(s) of the training program, or any portion thereof, and your video and/or audio as embodied therein, together with your name, professional information, photograph or likeness (including, without limitation, any photographs or other material provided by you).

I acknowledge that I have read and agree to the above

Recording Information and Release

Course Selections and Payment

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