Coaching Registration

Fields marked with * are required.

Coaching packages must be paid in full at time of purchase. In the space below enter the full amount for the package you have selected. Each individual gets one complimentary coaching session. If this is your complimentary session, enter 0.
By posting this electronic registration form with the following credit card information, I authorize Paige, Martin & Associates, Inc. (Pathways to Successful Living Seminars) to charge $ * (in US currency) to my credit card account.

By filling in my name and date below, I acknowledge that I have read, understand and agree to to all of the above terms and conditions.