Relationship Mastery Registration

AGREEMENT TO TERMS
Agreement to Terms*
- Yes, I would like to register for the Relationship Mastery live 2-day program with Dina Friedman. I understand and agree to the following Dina Friedman Academy (DFA) policies:
1. The $1,250 fee entitles the participant only to join the 2 day program in person with Dina Friedman. Only registered participants will be able to join this program. Since only a limited number of women will be allowed to join, participant takes full responsibility for payment in the event that she cannot attend.

2. The fee for the Relationship Mastery program is non-refundable, and cannot be credited or reimbursed. Once a participant registers, the DFA takes no responsibility if for any reason the registrant is unable to attend or participate in the program.

3. The information and handbook that are part of this program may not be used as a basis for any commercial practice, such as giving courses or classes without explicit permission from the Dina Friedman Academy.

We thank you for respecting the DFA policies, making it possible for us to continue providing you with our programs.

PARTICIPANT INFORMATION

Please fill out your personal information here. Please make sure this information is for the actual participant who will be registering for the program, and not the information for the cardholder account owner, if different.
Name*

First

Last
Address*

Street Address

City

State / Province / Region

ZIP / Postal Code

Country
Phone*
Phone
Email*
How Did You Hear About Our Products?*
Price*

Price:
I would like to join the 2-day Mastery Live seminar on Sunday and Monday, February 11 and 12, 2018 at 4 Parker Blvd. in Monsey, NY. I understand that only a limited number of women will be allowed to participate, and I take full responsibility for payment in the event that I cannot attend.
Total
$0.00
Billing Address*

Same as Participant Address

Street Address

Address Line 2

City

State / Province / Region

ZIP / Postal Code

Country
Credit Card*

American Express

Discover

MasterCard

Visa

Supported Credit Cards: American Express, Discover, MasterCard, Visa

Card Number

Expiration Date

Security Code

Cardholder Name
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Total
$0.00