Registration | Mpowered Families

Thank you for your interest in Mpowered Families

Mpowered Families Program Registration

Please complete the form below to begin your registration. Upon receipt, someone from our team will contact you to process payment of $5,500.00 per couple per year. Seats are limited to 20 couples per workshop and will be filled on a first come, first served basis. Your seat is not confirmed until payment is processed.

Similar to a high-performing team, the secret to building a high-performing family are the dynamics, characteristics, values, and the trust of each member. This assessment will help you assess the status of your shared vision, level of communication, and how clear, empowered, and aligned each family member is.

Your First NameYour Last NameYour name as you want it to appear on your name tag
Your Cell Phone
Your Email
Spouse's/Partner's First Name
Spouse's/Partner's Last Name
Your spouse's/partner's name as they want it to appear on their name tag
Spouse's/Partner's Cell Phone
Spouse's/Partner's Email
Your Mailing Address
Program Start Date Options
Please review the following options and make your selection below.
All workshops start at 9 AM and end at 4 PM.

April 2023 Program Start
4/26/2023
7/20/2023
10/24/2023
1/9/2024

July 2023 Program Start
7/12/2023
10/11/2023
1/10/2024
4/17/2024

October 2023 Program Start
10/12/2023
1/17/2024
4/3/2024
7/16/2024
Select your program start date
April 2023July 2023
October 2023
We would like to be notified when dates are announced for future classes.
How did you find out about Mpowered Families?
Discount Code (if applicable)
Referred by (if applicable)
Have you already completed the PRINT survey?
YesNoDo you or your spouse/partner have any dietary restrictions?
MEDIA RELEASE
‍I, the undersigned, hereby authorize Mpowered Journey to photograph me, take motion pictures of me, take video footage of me, and/or make electronic sound recordings of me (herein referred to as photographic or electronic reproductions).

I authorize the use of any such photographic or electronic reproductions of me for any purpose, including, but not limited to educational, promotional, and other public media as may be deemed appropriate by Mpowered Journey (I understand that I may be identifiable from such photographic or electronic reproduction).

I understand that there will be no financial or other remuneration for recording me, either for initial or subsequent transmission or playback.

I waive any rights, claims, or interest I may have to control the use of my identity or likeness in whatever media used.

THE UNDERSIGNED HAS READ THE FOREGOING RELEASE AND FULLY UNDERSTANDS IT.

Agreed and accepted by (please type your name below)

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