Step 1: Please complete the enrolment details

Name: The Happiness Hangout
SKU: 1131
Price: 299.00 AUD
Availability: InStock

Name of parent/guardian completing this form(Required)

First Last

Contact Phone No(Required)

Email Address(Required)

Your teen's full name(Required)

First Last

Preferred name(Required)

First

Current Age(Required)

DOB(Required)

Postal Address(Required)

Street Address Address Line 2 Suburb State Postcode

Health & Medical

Are there any health or medical concerns I should be informed of before working with your teen?(Required)

Yes

Please describe if applicable

Does your teen have any history of seizures or epilepsy? Note, this information is required to determine compatibility for hypnosis(Required)

Yes

Please describe if applicable

Does your teen have any history of psychosis or psychotic episodes? Note, this information is required to determine compatibility for hypnosis(Required)

Yes

Please describe if applicable

Please share a bit more about your teen

Emotional Wellbeing: what are the main things your teen is struggling with?(Required)

Intervention: What support, if any, have you accessed for your teen?

Please describe the outcomes of that support

Family Structure: Briefly outline the family structure, including parents, siblings and their order of birth(Required)

Support network: Does your teen have a good support network of family and / or friends?(Required)

Reasons for enrolment

What's the main reason you're enrolling your teen?(Required)

What outcomes would you most like for your teen from this program?(Required)

What interests you most about this program?(Required)

How did you find out about it?(Required)

Parental Consent

I consent to my child participating in all of the activities of this program, including group hypnosis.(Required)

Yes I consent

No I do not consent

Disclaimer

Liability I hereby release Amanda Cremonini, from any liability or claims that could be made against her concerning my mental and/or physical well-being during the work that has been outlined and agreed upon (now and in the future) by filling out this form. Scope of Practice I understand that Amanda Cremonini is not a licensed physician, psychologist, or medical practitioner of any kind and that hypnotherapy should not be considered a replacement for the advice and/or services, of a psychiatrist, psychologist, psychotherapist, or doctor.

Signature of parent/guardian(Required)

Today's date(Required)

Step 2: Please enter payment details.

The Happiness Hangout

$299.00

Delivered over a structured 10-week face-to-face group program, this will be a fun and transformational opportunity for teens to develop self-awareness, self-perception and practical skills to take care of their emotional well-being.

You are choosing to pay upfront in full

This product is non-refundable

2 in stock