About you.

All fields are required.

Full name Email Phone including country code Country and state or region where you usually attend sessions

Your Journey tier

Choose the tier that best reflects your current financial circumstances. The same care and commitment are offered at every tier.

Tier A$480USD / month20% off regular single-session ratesYour essential expenses leave you with limited financial flexibility.$120 per included session Tier B$640USD / month20% off regular single-session ratesYou can reliably cover your essential expenses and have some financial flexibility.$160 per included session Tier C$800USD / month20% off regular single-session ratesYou can comfortably cover your essential expenses and have substantial financial flexibility.$200 per included session

Choose your tier to see your monthly payment authorization below.

02

Your Journey agreement.

Please read and check each point.

I’m joining the Life Mentoring Journey because I’m ready and willing to commit to consistent, longer-term work with Wade, ideally twelve months or more. I understand that the preferred rate supports that ongoing commitment, and that shorter-term support is available through single sessions and four-session packages. There is no minimum term, and I remain free to cancel anytime. Your monthly paymentChoose your tier above to see your payment authorization.I authorize $480 USD at purchase and automatic monthly payments of $480 USD until I cancel, with renewal dates based on my purchase date. Each payment adds four 60-minute Zoom session credits to my account.I authorize $640 USD at purchase and automatic monthly payments of $640 USD until I cancel, with renewal dates based on my purchase date. Each payment adds four 60-minute Zoom session credits to my account.I authorize $800 USD at purchase and automatic monthly payments of $800 USD until I cancel, with renewal dates based on my purchase date. Each payment adds four 60-minute Zoom session credits to my account. I understand that meeting roughly once a week is recommended and that I’m encouraged to book all four sessions near the start of each billing cycle when possible. Preferred times aren’t guaranteed. Unused paid session credits accumulate without a cap or expiration while my membership is active. I understand that I need to cancel or reschedule an individual session using the link in my appointment confirmation at least 24 hours before its start time to keep my session credit. Sessions canceled or rescheduled with less notice, and no-shows, use a session credit and are nonrefundable, except for emergencies at Wade’s discretion. I understand that if I cancel my membership using the link in my payment emails, future monthly payments stop. Eligible unused paid sessions are refundable at the price I actually paid per session (normally $120 USD for my selected tier) (normally $160 USD for my selected tier) (normally $200 USD for my selected tier). Scheduled sessions must be canceled at least 24 hours ahead to qualify. I understand that refunds must be requested and have no cancellation penalty or processing-fee deduction. I understand that if Wade needs to cancel a session, I keep my session credit to reschedule or use later. I understand that if I want additional sessions and have no session credits remaining, the regular single-session rate for my selected tier applies: Tier A $150, Tier B $200 or Tier C $250 USD. I understand that Wade Robson is a Life Mentor and Somatic Experiencing Practitioner (SEP), offering coaching-based support for adults, not psychotherapy, diagnosis, medical treatment, or emergency care.

Membership cancellation and refunds

You can cancel your Life Mentoring Journey membership at any time using the subscription-management link in your payment emails. Future monthly payments will stop. Canceling an individual appointment does not cancel your membership.

To request a refund for eligible unused paid sessions, email me at wade@mentoringwithwade.com. Refunds are based on the per-session price you actually paid, with no cancellation penalty or processing-fee deduction. Scheduled sessions must be canceled at least 24 hours before their start time to qualify.

Once the eligible refund amount is confirmed, I’ll initiate your refund within five business days. The time it takes to appear in your account depends on your bank or payment provider and is outside my control.

If you would like to keep any already-booked sessions, please let me know when you request your refund.

For emergency cancellations, refund requests or scheduling help, email wade@mentoringwithwade.com.

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Consent and safety.

Please read and check each point.

If you cannot truthfully confirm the first statement below about your current stability and need for care, please pause here and seek appropriate licensed professional or emergency support.

I confirm that I am stable enough for coaching-based work and am not currently in a mental health crisis, at immediate risk of harming myself or others, or needing urgent clinical care. I will seek licensed medical or psychological care when needed and contact emergency services for urgent help.

I understand that participation is voluntary. I may decline an exercise or pause or stop a session. Strong feelings may arise, results are not guaranteed, and I remain responsible for my choices, actions, and wellbeing. I understand that Wade will treat what I share as confidential, subject to disclosures I permit, those required by law, and those legally permitted for serious safety concerns, including suspected abuse.

Emergency contact.

Please provide the name, phone number, and email of a trusted emergency contact, who may be contacted if serious safety concerns arise.

Emergency contact name Emergency contact phone Emergency contact email

04

Your life self-assessment.

Please complete every part of the self-assessment. For each area, choose Poor / Okay / Great and add a brief explanation. Then answer the two questions about your greatest concern and greatest hope.

Brief answers are welcome. You choose how much detail to share.

Physical Health

Briefly elaborate on the state of your Physical Health

Mental + Emotional Health

Briefly elaborate on the state of your Mental & Emotional Health

Relationships

Briefly elaborate on the state of your Relationships

Creative Life

Briefly elaborate on the state of your Creative Life

Work / Livelihood

Briefly elaborate on the state of your Work/Livelihood

Which area or areas of your life concern you most? What is your greatest hope for your Life Mentoring Journey?

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Review and consent.

Your selected membership

Choose your tierTier A · $480 USD / monthTier B · $640 USD / monthTier C · $800 USD / month

Your chosen tier and monthly charge will appear here.Your selected tier rate is charged at purchase, then that same amount is charged automatically each month from your purchase date until you cancel. Each payment adds four 60-minute Zoom session credits to your account. No setup fee.

How your responses are handled: Your responses are stored electronically as part of your private client record. You receive an email copy of your agreement and self-assessment, and Wade is notified that your form has been received.

Privacy and record retention

I keep relevant intake, agreement, session, booking and payment records to support our work, administer your membership, and meet legitimate business and legal needs, including responding to complaints or claims. Records may be kept long term for as long as reasonably needed for these purposes. I periodically review that need and securely delete information I no longer need, unless it must be retained by law.

For questions about your information or requests for access, correction or deletion, email wade@mentoringwithwade.com. I verify your identity and review requests under applicable requirements. Some records may need to be retained for valid business or legal reasons; I will explain any limits that apply.

I confirm that I am 18 or older, have read and understood the agreement above, and consent to participate in The Life Mentoring Journey with Wade Robson.

Submit to save your form and continue to membership purchase. Your agreement and self-assessment copy will follow by email. No payment is taken on this form.

Agreement wording LMJ-ONB-2026-11-07-R14 · Commercial policy Version Five