Client Contract Form



Please read this consent form completely and thoroughly. Signing this form upon start of services indicates you clearly understand our relationship and take responsibility for the same. If you have any questions, please clarify them before you sign the form. This benefits both you and Authentic Journeys as we move forward.

All fields in this form are compulsory fields and need to be filled appropriately.

Basic details:

Your Full Name: Email Address:
Phone Number: Home Address:
My Chosen Package:
Enter the Package name/price.
My role and responsibility as a Client:

  1. Correct contact information has been provided. If it changes, I will inform Jennifer Kumar.
  2. I understand if we have sessions via the phone or the Internet, I am responsible for contacting Jennifer Kumar on time and I am responsible for the phone or Internet charges in addition to the coaching fees.
  3. Jennifer Kumar is a life coach/consultant. She helps me brainstorm, assess and create plans to enhance my life. I understand the ideas that arise from her sessions are not prescriptions. I take full responsibility for the decisions I make following the discussions/coaching sessions with Jennifer Kumar. I am responsible for my mental, emotional, physical and overall health.

Payments, Late Policy, Late Fees and Penalties:

  1. The package price MUST be paid in full before delivery of services by cash, check or bank transfer. All invoices must be paid before the INVOICE DUE DATE. Those who fail to do so will be charged a penalty of an additional 25% of the total invoice as a late fee.
  2. For example, if the total invoice is Rs. 16,000 and it's not paid by the invoice due date, you will be charged an additional Rs. 4,000 as a late fee.
  3. I will call and cancel 24 hours or more in advance to respect Jennifer Kumar's time and avoid cancellation fees
  4. I as the client will pay a 25% penalty (of the hourly rate) in addition to the hourly rate for the scheduled session if:
    1. I am more than 15 minutes late or
    2. I cancel less than 24 hours before the appointment.
  5. Barring unforeseen emergencies.
    For example: If the normal hourly rate is Rs. 1000. The late fee is 25% or Rs. 250. The total that will be charged for this MISSED session will be Rs. 1250.
  6. My coach, Jennifer will refund me 25% (of the hourly rate) as a penalty to her if:
    1. She is more than 15 minutes late or
    2. She cancels less than 24 hours before the appointment.
  7. Barring unforeseen emergencies.
    For example: If the hourly rate is Rs. 1000. 25% of this is Rs. 250. The coach will refund the client Rs. 250 ONLY for this.
  8. If the weather or cultural factors (strikes/bandhs for Kochi-based clients) force us to cancel in-person meetings, we can decide to meet by phone or Skype as appropriate
  9. I understand that I must be regular in attending sessions. Continuity is important to learning, absorbing and using the information learned. I must attend at least two classes every month. If more than 30 days pass with no sessions attended, the contract will cancel and a 50% cancellation fee will be deducted from the remainder of my pre-paid fees. The remainder will be refunded to me.
  10. This applies for those purchasing packages of classes at 5 classes or more.
  11. If I as the client discontinue the contract before its completion, I will be refunded the hourly rate multiplied by the number of hours, less a 50% administration fee.
  12. For example, if 3 hours remain, and the hourly rate was Rs. 900, the initial refund is Rs. 2700 less 50% (Rs. 1350).
  13. If the coach discontinues the contract before completion, the client will be refunded the number of hours multiplied by the hourly rate with no further reductions.
  14. If the calls or e-mails between sessions are extensive and take more than 15 minutes to complete, I will be billed ¼ (one-fourth) of the hourly rate per each 15 minute interval.

Agreement and Confirmation
I, as the client, attest that I have read, understood and checked the items on this list myself. I attest that if I had any questions about the items in the lists above, I would have discussed them with Jennifer Kumar before I signed this form. I understand by signing this form, it states I have read and understood my role as a client and Jennifer Kumar's role as a life coach/tutor.

By filling out this form and submitting it digitally, it acts as a legally binding agreement between you and me that we will work together to the best of our abilities to achieve your goals.

This form is being submitted by:
(Name, as provided in Basic Details )
On the date of:




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