Kids at Risk for Diabetes LLC
One on One 3 month Phone Consulting Service
**If Client is under the age of 18 years old, a parent or legal guardian must sign on his/her behalf. Please change signature accordingly to include both the parent’s and the child’s signatures.
Company agrees to provide one-on-one consulting and support to parents of children at risk for chronic disease due to obesity. During this time period, Clients will schedule appointment times at least 3 days in advance. Client is entitled to one email correspondence per week. If client corresponds more than once a week, coach may delay response and limit email guidance to once a week. Email correspondence will not substitute for phone consultation. A Facebook page will also be provided for community support (herein referred to as the “Program”). Client agrees to abide by all policies and procedures as outlined in this agreement as a condition of their participation in the Program.
I have used care in preparing the information provided to you, but this Program and my Program materials are being provided as self-help tools for your own use and for informational and educational purposes only. There are many factors that influence results, so no guarantees can be made as to the results you will experience through this Program. You agree that I am not responsible for your physical, mental, emotional and spiritual health or for any other result or outcome that you may experience through this Program.
Client understands Coach is not an employee, agent, lawyer, doctor, registered dietician, psychotherapist, nutritionist, psychologist, or other licensed or registered professional. Although at this time, I am an Indiana state registered nurse, I cannot and do not practice in any state outside of Indiana. I also cannot predict when I will officially retire and allow my registered nurse license and my certification for diabetes education to expire. Therefore I should not be considered a practicing (licensed) registered nurse or certified diabetes educator at any time and I am not holding myself out as such at any time or giving medical or nursing advice in any capacity. Coach will not act as a therapist providing psychoanalysis, psychological counseling or behavioral therapy. Client understands this Program will not prescribe or assess micro-and macronutrient levels; provide health care, medical or nutrition therapy services; or diagnose, treat or cure any disease, condition or other physical or mental ailment of the human body. Client understands if they should experience any such issues they should see their registered physician or other practitioner as determined by their own judgment.
If the Client is under the care of a health care professional or currently uses prescription medications, the Client should discuss any dietary changes or potential dietary supplements use with his or her doctor, and should not discontinue any prescription medications without first consulting his or her doctor. Client understands that the information in this Program is NOT medical or nursing advice and is not meant to take the place of seeing licensed health professionals.
**Initials _____ (if client is under 18 years old, please include parent signature.)
Legal Parent/guardian signature: _____________________________________
NOT MEDICAL, MENTAL HEALTH, OR RELIGIOUS ADVICE.
My Programs, Services, Program Materials, Products, Facebook Community, Website or any of its Content are not to be perceived as or relied upon in any way as medical advice.
I am not, nor am I holding myself out to be a doctor/physician, nurse practitioner, physician’s assistant, advanced practice nurse, or any other medical professional (“Medical Provider”), psychiatrist, psychologist, therapist, counselor, or social worker (“Mental Health Provider”), registered dietician or licensed nutritionist, or member of the clergy. Although, at this time, I am an Indiana state registered nurse, I can not officially practice in any state outside of Indiana. I also can not predict when I will officially retire and allow my registered nurse license to expire or my NCBDE certification for diabetes educators to expire as well. Therefore, I should not be considered a practicing (licensed) registered nurse or certified diabetes educator at any time. As a Professional Wellness Coach hosting my Programs, Services, Program Materials, Products, Facebook Communities, Website and its Content, I am not providing health care, medical or nutritional therapy services, or attempting to diagnose, treat, prevent or cure any physical, mental or emotional issue, disease management or chronic conditions management. The information provided in or through my Programs, Services, Program Materials, Facebook Content, and/or Website and it’s Content pertaining to your wellness, pediatric issues, chronic disease management, diabetes management, weight lose therapy, nutritional management, dyslipidemia, emotional health, mental health, macrovascular or microvascular complications, ophthalmology, neuropathy, nephropathy, dental health, podiatry problems, retinopathy issues, sexual issues, exercise, sleep therapy or any other aspect of your life is not intended to be a substitute for the professional medical advice, diagnosis or treatment provided by your own Medical Provider or Mental Health Provider. You agree and acknowledge that I am not providing medical advice, mental health advice, or religious advice in any way. Always seek the advice of your own Medical Provider and/or Mental Health Provider regarding any questions or concerns you have about your specific health or any medications, herbs or supplements you are currently taking and before implementing any recommendations or suggestions from our Programs, Services, Program Materials, Facebook Content, Website and its Content. Do not disregard medical advice or delay seeking medical advice because of information you have read in this Program, Services, Program Materials, Facebook Content, Website and it’s Content. Do not start or stop taking any medications without speaking to your own Medical Provider or Mental Health Provider. If you have or suspect that you have a medical or mental health problem, contact your own Medical Provider or Mental Health Provider promptly. The information contained in this Program, Services, Program Materials, Products, Facebook Content, Website and it’s Content has not been evaluated by the Food and Drug Administration.
Children’s Online Privacy Protection Act Compliance
We do not collect any information from anyone under 13 years of age in compliance with COPPA (Children’s Online Privacy Protection Act), and our Website and its Content is directed to individuals who are at least 13 years old or older.
Total price of this One-on-One (initial) 3 month Whole Family Consulting Program is $1897.00 American dollars. If paying by PayPal, or debit card or credit card via PayPal, you give us permission to automatically charge your credit card or debit card as payment for your program without any additional authorization, and you will receive an electronic receipt. If I choose to provide you with a PayPal invoice instead, you are required to manually pay it by the date due on the invoice or your Program will be put on hold until payment is made. If payment is not received by the date due or there is a problem with the payment transaction or method, you will be notified by e-mail and then have a 3 day grace period to make the payment following the due date, otherwise your Program will be put on hold. If no payment is made within the 3 day grace period, the Program will automatically terminate and you will no longer be granted access.
It is Company’s intention for Client to be happy with the Program. However, because Company has invested considerable time and effort in the Program, if Client decides to withdraw at any time for any reason, Client is still fully responsible for making all Program payments, and no refunds will be provided during the three month initial program.
5. PROGRAM STRUCTURE.
● Email access: Julie@kidsatriskfordiabetes.com
Expectations and Guidelines:
● Come prepared.
● Devote my full attention to you during our time together.
● Serve as your accountability partner and supporter.
● Stretch you outside of your comfort zone.
● Offer support, encouragement, feedback and guidance.
● Show up on time without distractions.
● Give 100% of your effort and fully commit to the Program.
● Come fully prepared for our time together.
● Use your best efforts to complete all action steps.
● Promptly provide payment for the Program.
● Be open to new ideas and willing to stretch and grow.
● Ask any questions you may have as they arise.
● Understand that the power of the coaching relationship can only be granted by you, and commit to making the relationship powerful. If you see that the coaching is not working as you desire, communicate and take action to return the power to the relationship.
Rescheduling: If you need to reschedule an appointment, you need to do so at least 48 hours in advance of your scheduled time by sending an e-mail to me.
Cancellation: Our time together is important. If you need to cancel your appointment, you need to do so at least 48 hours in advance of your scheduled time by sending an e-mail to me. If you do not contact me at least 48 hours in advance, this will be considered a missed appointment.
Missed Appointment: There can be a rare occasion where you miss your appointment altogether or you forget to let me know at least 48 hours in advance that you need to cancel or reschedule, so you are allowed 1 “Get Out of Jail Free” missed appointment. However, you are only permitted to miss 1 appointment during the Program. If you miss more than 1 appointment, your Program will automatically terminate and you will not have the opportunity to reschedule or to receive a refund.
This initial Program is 3 months long and begins on the first Monday after payment is received. (“Term”). Client understands that a relationship with Company does not exist between the Parties after the conclusion of the Program. If the Parties desire to continue their relationship, a continuing agreement will be entered into upon agreement of both parties.
Company is committed to providing all clients in the Program with a positive Program experience. By signing below, Client agrees that the Company may, at its sole discretion, terminate this Agreement and limit, suspend or terminate Client’s participation in the Program without refund or forgiveness of monthly payments if Client becomes disruptive or upon violation of the terms. If Client decides to terminate this Agreement, no refunds will be issued.
This Agreement is considered a mutual non-disclosure agreement. Both Parties agree not to disclose, reveal or make use of any information learned by either party during discussions, Or otherwise, throughout the Term of this Program (“Confidential Information”). Confidential Information includes, but is not limited to, information disclosed in connection with this Agreement, and shall not include information rightfully obtained from a third party. Both Parties shall keep all Confidential Information strictly confidential by using a reasonable degree of care, but not less than the degree of care used by it in safeguarding its own confidential information. The obligation of the Parties hereunder to hold the information confidential does not apply to information that is subsequently acquired by either Party from a third party who has a bona fide right to make such information available without restriction. Both Parties agree that any and all Confidential Information learned as of the Effective Date shall survive the termination, revocation, or expiration of this Agreement.
9. COMPELLED DISCLOSURE OF CONFIDENTIAL INFORMATION.
Notwithstanding anything in the foregoing, in the event that Client is required by law to disclose any of the Confidential Information, Client will (i) provide Company with prompt notice of such requirement prior to the disclosure, and (ii) give Company all available information and assistance to enable Company to take the measures appropriate to protect the Confidential Information from disclosure.
10. INTELLECTUAL PROPERTY RIGHTS.
Company retains all ownership and intellectual property rights to the Program content and materials provided to Client through the Program, including all copyrights and any trademarks belonging to Company. The Program content and materials are being provided to you for your individual use only and with a single-user license which means that you are not allowed or authorized to share, copy, sell, post, distribute, reproduce, duplicate, trade, resell, exploit, or otherwise disseminate any portion of the Program or Program materials, electronically or otherwise, for business or commercial use, or in any other way that earns you money, without my prior written permission.
Further, by signing below, Client agrees that if Client violates, or displays any likelihood of violating, any of Client’s agreements contained in this paragraph, Company will be entitled to injunctive relief to prohibit any such violations and to protect against the harm of such violations.
If there is a dispute between the Parties, Client agrees to not publicly or privately make any negative or critical comments about the Program, Company’s business or me, or to communicate with any other individual, company or entity in a way that disparages the Program or harms the Company’s reputation in any way, including on social media. In arbitration or when required by law, of course, you are not prohibited from publicly sharing your thoughts and opinions
Client agrees to indemnify and hold harmless Company, its affiliates, and its respective officers, directors, agents, employees, and other independent contractors from any and all claims, demands, losses, causes of action, damage, lawsuits, judgments, including attorneys’ fees and costs, arising out of, or relating to, Client’s participation or action(s) under this Agreement. Client agrees to defend against any and all claims, demands, causes of action, lawsuits, and/or judgments arising out of, or relating to, the Client’s participation under this Agreement, unless expressly stated otherwise by Company, in writing.
Technology Disclaimer. We try to ensure that the availability and delivery of our Programs, Services, Program Materials, Products, Facebook Community or Website and its Content is uninterrupted and error-free. However, we cannot guarantee that your access will not be suspended or restricted from time to time, including to allow for repairs, maintenance or updates, although, of course, we will try to limit the frequency and duration of suspension or restriction. To the fullest extent permitted by law, we will be not be liable to you for damages or refunds, or for any other recourse, should our Programs, Services, Program Materials, Facebook Community or Website or its Content become unavailable or access to the them becomes slow or incomplete due to any reason, such as system back-up procedures, internet traffic volume, upgrades, overload of requests to the servers, general network failures or delays, or any other cause which may from time to time make our Programs, Services, Program Materials, Facebook Community, Website or its Content inaccessible to you.
We have a no spam policy and provide you with the ability to opt-out of our communications by selecting the unsubscribe link at the footer of all e-mails. We have taken the necessary steps to ensure that we are compliant with the CAN-SPAM Act of 2003 by never sending out misleading information. We will not sell, rent or share your email address.
Errors and Omissions. We make no warranty or guarantee as to the accuracy, timeliness, performance, completeness or suitability of the information on our Programs, Services, Program Content, Facebook Content, Website or its Content. Every effort has been made to present you with the most accurate, up-to-date information, but because the nature of scientific research is constantly evolving, we cannot be held responsible or accountable for the accuracy of our content. We assume no liability for errors or omissions on the Program, Services, Program Content, Facebook Pages Content, Website, its Content, or in other information referenced by or linked to the site. You acknowledge that such information may contain inaccuracies or errors to the fullest extent permitted by law.
Links to Other Websites. We may provide links and pointers to other websites maintained by third parties which may take you outside of our Program or Program Materials or Facebook Community or Website or its Content or Facebook Materials. These links are provided for your convenience and the inclusion of any link in our Programs, Program Materials, Facebook Content or Website or its Content to any other website does not imply our endorsement, sponsorship, or approval of that website or its owner. We do not endorse and we are not responsible for the views, opinions, facts, advice, statements, errors or omissions provided by external resources referenced in our Programs, Services, Program Materials, Facebook Content, Website or its Content or Facebook pages or their accuracy or reliability. We have no control over the contents or functionality of those websites and so we accept no responsibility for any loss, damage, or otherwise that may arise from your use of them. It is your responsibility to review the terms and conditions and privacy policies of those linked websites to confirm that you understand and agree with those policies.
Limitations on Linking and Framing. You may establish a hypertext link to our Program, Services, Program Materials, Facebook pages, Website or Content so long as the link does not state or imply any sponsorship, endorsement by, or ownership by in our Website or Content and does not state or imply that we are have sponsored, endorsed or have ownership rights in your website. However, you may not frame or inline link our Content without our written permission.
By purchasing and/or using our Programs, Services, Program Materials, Products, Website and its Content in any way or for any reason, you also implicitly agree to our full Disclaimer which may be found on this Website.
All correspondence or notice required regarding the Program shall be made to me by e-mail at Julie@kidsatriskfordiabetes.com and to you at the e-mail address you provided during your enrollment in the Program. Should your e-mail address, billing information, or contact information change at any time throughout the Program, it is your responsibility to provide your updated information to me within 3 days of any change.
14. DISPUTE RESOLUTION.
If a dispute is not resolved first by good-faith negotiation between the Parties to this Agreement, every controversy or dispute to this Agreement will be submitted to the American Arbitration Association. The arbitration shall occur within ninety-(90)-days from the date of the initial arbitration demand and shall take place in Columbus, Indiana USA. The Parties shall cooperate in exchanging and expediting discovery as part of the arbitration process and shall cooperate with each other to ensure that the arbitration process is completed within the ninety-(90)-day period. The written decision of the arbitrators (which will provide for the payment of costs, including attorneys’ fees) will be absolutely binding and conclusive and not subject to judicial review, and may be entered and enforced in any court of proper jurisdiction, either as a judgment of law or decree in equity, as circumstances may indicate.
15. GOVERNING LAW.
This Agreement shall be governed by and construed in accordance with the laws of the state of Indiana, regardless of the conflict of laws principles thereof.
16. ENTIRE AGREEMENT; AMENDMENT; HEADINGS.
This Agreement constitutes the entire agreement between the Parties with respect to its relationship, and supersedes all prior oral or written agreements, understandings and representations to the extent that they relate in any way to the subject matter hereof. Neither course of performance, nor course of dealing, nor usage of trade, shall be used to qualify, explain, supplement or otherwise modify any of the provisions of this Agreement. No amendment of, or any consent with respect to, any provision of this Agreement shall bind either party unless set forth in a writing, specifying such waiver, consent, or amendment, signed by both parties. The headings of Sections in this Agreement are provided for convenience only and shall not affect its construction or interpretation.
This Agreement may be executed in one or more counterparts (including by means of facsimile or electronic mail via portable document format), each of which shall be deemed an original but all of which together will constitute one and the same instrument.
Should any provision of this Agreement be or become invalid, illegal, or unenforceable under applicable law, the other provisions of this Agreement shall not be affected and shall remain in full force and effect.
The waiver or failure of Company to exercise in any respect any right provided for herein shall not be deemed a waiver of any further right hereunder.
This Agreement may not be reassigned by either Party without express written consent of the other Party.
21 CLIENT RESPONSIBILITY; NO GUARANTEES.
Client accepts and agrees that Client is 100% responsible for its progress and results from the Program. Company will help and guide Client; however, participation is the one vital element to the Program’s success that relies solely on Client. Company makes no representations, warranties or guarantees verbally or in writing regarding Client’s performance. Client understands that because of the nature of the program and extent, the results experienced by each client may significantly vary. By signing below, Client acknowledges that there is an inherent risk of loss of capital and there is no guarantee that Client will reach its goals as a result of participation in the Program and Company’s comments about the outcome are expressions of opinion only. Company makes no guarantee other than that the Services offered in this Program shall be provided to Client in accordance with the terms of this Agreement.
[Signature Page to Follow]
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IN WITNESS WHEREOF, the Parties, intending to be legally bound, have executed this Client Agreement as of the date first indicated. Upon signing, the parent or legal guardian indicates they have legal custody of the child/children involved in this program.
Kids at Risk for Diabetes LLC
Client signature and date: ___________________________ _________________________________
Julie Stelting CEO
(to be signed and dated after received) Parent signature required if client is under 18 years old.
To be returned to Julie@Kidsatriskfordiabetes.com before program begins.
Date Received: ____________________
Date Program began: ________________
Date Program to end: ________________
Date Program extended: __________________