C O U R S E   E N R O L L M E N T

NOTE:
This form is for those who have never taken an online course with Ralph.

If you have filled out this form before when singing up for previous online courses with Ralph, please skip the form and scroll down for payment options.

Any information you offer here will NOT be shared and will be kept in the strict confidentiality. The purpose of this form is to ensure I am able to provide the safest and deepest possible experience for you while bringing to your attention that there are risks

Name *
Name
I understand that Ralph's online courses are not psychotherapy. Even though they teach psychotherapeutic methodologies, they are intended to teach me skills I can use for my personal growth. I understand that the practices in this course can elicit difficult and painful emotional material and that the nature of Ralph's course is to offer me skills to relate to that material directly instead of avoiding it. I declare that I have the psychological stability to handle whatever may come up. I am responsible for my participation in the class and any psychological work that I choose to do, and I will not hold Ralph De La Rosa responsible for any pain or damages that may occur.
Self-Investment Options

It is my policy to keep wisdom and healing accessible to everyone. If you find the cost of the program truly prohibitive, please write me at ralph@ralphdelarosa.com