QuickStep Client Contract

Please read carefully and submit your customize contract by completing the form below and submitting it for approval. Someone will contact you as soon as possible (usually within 24 hours).

Choose your Length of Contract.

Choose when to Start.

Choose from One or Two Sessions per Month.

Choose a Coach (or discuss with the Coordinator)

Choose from Monthly or Quarterly payments. 

Name:*

First

Last

Home Phone:*

Area Code

-

Phone Number

Cell Phone:*

Area Code

-

Phone Number

E-mail:*

Billing Address:*

Street AddressCityState / Province / RegionPostal / Zip Code

Initial Length of Contract:*

Select oneMonth to MonthQuarterly (3 months)

When would you like to start?*

Number of Sessions per month:*

1

2

I would like to request the following QuickStep Coach (if you leave blank, the coordinator will contact you):

Choose a CoachBilly BellBill TinsleyBrett MosherCharlie BrownDale LeeDanny PickensDarrell HornDavid AdamsDavid VelaDelcia ChisolmDiane LaneEvelyn OfongJohn HortonLarry RheaMario MartinezMichael BellMike McKinneyMorgan MaloneNoe TrevinoRuss RaineyTim Randolph

AGREEMENTS: Client calls the coach at the scheduled time (Unless the coach & client agree otherwise.) Sessions will be scheduled at a convenient time for both client and coach. Sessions will be 30 - 40 minutes in duration. Client pays coaching fees in advance. No bill is sent from the QuickStep Coaching office unless payment is overdue. As soon as payment is made, coaching will continue. It will be your responsibility to go online and make full payment prior to each month's session(s), unless you make other arrangements (paying quarterly or annually). Upon expiration of your contract, you will have the opportunity to continue appointments on a monthly basis.*

Yes, I agree to these terms.

No, I do not agree to these terms.

CLIENT RELEASE OF LIABILITY: Life Coaching is a service that provides personal coaching to specific individuals and/or groups. Coaching is in no way to be construed or substituted as psychological counseling or any other type of therapy or medical advice. Our coaches will at all times exercise their best professional efforts, skills and care of ensuring that you are coached to meet your personal goals. Coaches are not liable legally or otherwise, for the actions you may or may not undertake as a result of the life coaching sessions. No assumption of responsibility is made, or given; and if you request such advice, you agree not to hold your coach (Provider) or Quickstep Coaching, responsible or liable in any form or fashion, for such actions taken of your own accord. The method and process by which these sessions are conducted in no manner whatsoever, written or verbal, constitute an agreement or liability on the part of the provider and is acknowledged to be different in many ways than clinical and medical counseling. You (the client) agree that using any of these life-coaching services is entirely at your own risk; and is an acceptance of this release. Life coaching services are provided "as is", without warranty of any kind, either expressed or implied, including without limitation any warranty for information services, coaching, uninterrupted access, or products and services provided through or in connection with the service. The client takes full responsibility in the decisions they make after being coached as well as the consequences. *

Yes, I agree to these terms.

No, I do not agree to these terms.

CANCELLATIONS AND RE-SCHEDULING: If you need to reschedule your appointment, please give your coach at least a 24-hour notice if possible. There is no guarantee that your coach will be able to re-schedule, but the coach will make every effort once you give a 24-hour notice. If you have an emergency, rescheduling will be calendared as the coach’s schedule allows. Cancelled sessions need to be made up within the month. There may be a time that your coach will need to reschedule as well, but he or she will let you know as far in advance as possible.*

Yes, I agree to these terms.

No, I do not agree to these terms.

TERMINATION: Cancellation of this agreement must be by email to ed@QuickstepCoaching.com. Payment made for current month shall be considered full payment for coaching unless there is an unpaid balance. In the event of fees owed at the time of cancellation, full payment is due and payable.*

Yes, I agree to these terms.

No, I do not agree to these terms.

CONFIDENTIALITY - is the key to creating a successful coaching environment and gives you confidence to talk more freely. This coaching relationship, as well as all information (documented or verbal) that the Client shares with the Coach as part of this relationship, is bound to confidentiality by the ICF Code of Ethics but is not considered a legally confidential relationship (like in Medicine or Law). Part of respecting your confidentiality is to be clear and honest with you about the limits to confidentiality and to avoid areas of possible misunderstanding. COACHING LOG – as part of an ongoing professional coach credentialing process, your coach may document client names, contact information and session times in a confidential log. The log does not include the topics discussed. This log of cumulative coaching hours is periodically submitted to certifying bodies (e.g. International Coach Federation) that also hold it in confidence. Occasionally these certifying bodies audit the submitted logs, so it is possible although unlikely you may be contacted to verify that a coaching relationship existed. In this unlikely situation we appreciate your cooperation that enables your coach to continue professional development. SUPERVISION AND CALL RECORDINGS – calls may be recorded without further permission for confidential use for the coach's professional development. Your coach may share these recordings and/or discuss sessions with mentors, supervisors, legal advisors or credentialing boards when he deems appropriate for his learning and professional development. The coach will make good faith efforts to ensure these parties keep everything strictly confidential. Whenever possible, client names are not mentioned and identifying personal details are omitted or changed. TEACHING SITUATIONS AND CASE STUDIES – your coach may mention topics or situations discussed but will be careful to not to mention personally identifying details without your permission. THREATS OF VIOLENCE – If you make threats of violence or inform us of a major crime against yourself or others, you are, by so doing, giving us consent to disclose to the proper authorities whatever information about you we deem necessary, in our sole discretion, to protect any person(s) directly or indirectly threatened.*

Yes, I agree to these terms.

No, I do not agree to these terms.

Payment Options:

Choose one or two sessions per month:*

How would you like to pay?One session per month / $150 monthlyOne session per month / $450 quarterlyTwo sessions per month / $225 monthlyTwo session per month / $675 quarterly

I have read, understand and agree to this contract:*

Yes, I agree to these terms.

No, I do not agree to these terms.

Today's Date:*

Word Verification:

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For More Information about Coaching Guidelines, CLICK HERE.